Carcinoma papilífero em cisto do ducto tireoglosso: a tireoidectomia é necessária?

Introducao: o cisto do ducto tireoglosso (CDT) e a doenca congenita mais frequente na regiao cervical. A presenca de neoplasia maligna associada a esse cisto e pouco comum e de dificil diagnostico pre-operatorio. Objetivo: apresentar a experiencia com carcinoma papilifero em CDT. Pacientes e Metodo: foram revistos 35 pacientes consecutivos submetidos a resseccao de CDT e estudados tres cssos de carcinoma papilifero dentro do cisto, com analise do tratamento dos mesmos. Resultados: a incidencia de carcinoma papilifero foi de 8,5% dos cistos nessa serie, sendo duas mulheres e um homem e idade media de 27,3 anos (variacao de 25 a 32 anos). Dois pacientes tiveram diagnostico apos cirurgia de Sistrunk e um apresentava biopsia aspirativa por agulha fina pre-operatoria sugestiva de neoplasia. Todos os casos foram conduzidos com tireoidectomia total, um deles pela tecnica video-assistida, com pesquisa de corpo inteiro com I131 apos a cirurgia. Em um paciente, foi encontrada neoplasia prim[aria na tireoide. Conclusao: o carcinoma papilifero em CDT e pouco frequente. Embora o tratamento seja controverso, nosso ponto de vista e que a tireoidectomia total deva ser indicada, complementando a resseccao do cisto devido a possibilidade de tratar-se de tumor metastico e para facilitar o seguimento posterior. A tecnica video-assistida pode ser utilizada para realizar a tireoidectomia total por tratar-se, em geral, de glândulas de tamanho normal (AU) Introduction: the Thyroglossaal duct cyst(TDC) is the most common congenital disease of the cervical region. The presence of associated malignant neoplasm in the cyst is uncommon and is difficult to perform the preoperative diagnosis. Objective: to present our experience with papillary carcinoma in the TDC. Patients and Methods: we reviewed 35 consecutive patients submited to TDC resection with three cases of papillary carcinoma in the cyst and analyzed the treatment. Results: the incidence in this serires was 8.5% of papillary carcinoma in the cysts, with two women and one man, whose mean age was 27.3 years (range, 25 to 32). Two patients were diagnosed after the Sistrunk procedure and one had preoperative fine needle aspiration biopsy suggestive of neoplasm. All patients underwnt complementary total thyrodectomy, one of them underthe videoassisted technique, and total body scintigraphy. In one patient, papillary carcinoma was found in the thyroid gland. Conclusion: the papillary carcinoma in TDC is an uncommon entity. The treatment is controversal, but in our pont of view the total thyroidectomy is indicated as a complement to the cyst resection because it can be metastatic, and to facilitate the follow-up. The videoassisted technique may be used to perform the total thyroidectomy because the glands have commonly normal size (AU)