Thyroglossal duct papillary carcinoma with squamous metaplasia in a 12-year old female and review of literature

We are reporting a case of a 12-year old African-American female who presented with a six-month history of a painless, enlarging, midline neck mass. Imaging demonstrated a 4-cm solid mass with cystic components and calcifications. Differential diagnosis included dermoid tumor, teratoma, sarcomatous lesion, thyroglossal duct cyst carcinoma, and ectopic thyroid tissue with malignant transformation. Preoperative thyroid studies were unremarkable. Patient underwent Sistrunk procedure and cervical lymph node dissection. Pathology reported a diagnosis of papillary carcinoma with squamous metaplasia arising from a thyroglossal duct cyst with three of five positive lymph nodes. Post-operative thyroid studies and imaging were unremarkable. After literature review on pediatric cases of thyroglossal duct carcinomas, the decision was made to forgo thyroidectomy and opt for close follow-up. Thyroglossal duct carcinoma is a rare pediatric tumor with approximately 26 cases reported in the literature. Best practice for the extent of surgical resection and post-operative management is still evolving as we gather data on long-term outcomes.