J Korean Surg Soc.  2011 Dec;81(Suppl 1):S12-S16. 10.4174/jkss.2011.81.Suppl1.S12.

Primary papillary carcinoma originated from a branchial cleft cyst

• Cho JS
• Shin SH
• Kim HK
• Lee JS
• Park MH
• Yoon JH
• Jegal YJ

• KMID: 1445777
• DOI: http://doi.org/10.4174/jkss.2011.81.Suppl1.S12

Abstract

Although branchial cleft cysts are common, papillary carcinomas arising from them are rare. Here we report a 41-year-old woman with papillary carcinoma originating from a right lateral branchial cleft cyst without any evidence of a papillary carcinoma in the thyroid gland. The patient underwent right lateral neck dissection followed by total thyroidectomy. We then confirmed papillary carcinoma arising from the branchial cleft cyst through microscopic and immunohistochemical staining with thyroglobulin (TG), thyroid-associated transcription factor-1 (TTF-1) and p63. It is the 10th case worldwide describing papillary carcinoma in a branchial cleft cyst with a review of the literature on the features of the disease and discussion of the role of immunohistochemical staining with TG, TTF -1 and p63. In conclusion, it should be emphasized that the surgeon must be cautioned of the possibility of primary papillary carcinoma in the branchial cleft cyst.

Keyword

Branchioma; Thyroid neoplasms; Papillary carcinoma

MeSH Terms

Adult
Branchial Region
Branchioma
Carcinoma, Papillary
Female
Humans
Neck Dissection
Thyroglobulin
Thyroid Gland
Thyroid Neoplasms
Thyroidectomy
Thyroglobulin

Figure

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  Fig. 1 Neck ultrasonography shows a flat ovoid 0.5 cm mass in the thyroid (A, B) and an oval 3.0 cm size solid mass on the cystic wall of the right lateral neck at level III (C, D).

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  Fig. 2 Axial computed tomography demonstrating a uni-loculated cystic lesion measuring about 3.0 cm in diameter, just lateral to right internal jugular vein at the level of cricoid cartilage. Note the high-density area within the cystic lesion consistent with focal calcification. The mass abuts the right internal jugular vein medially and the sternocleidomastoid muscle posteriorly.

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  Fig. 3 Papillary carcinoma originated from a branchial cleft cyst. Intracystic papillary projections are observed (A, H&E, ×20). The cyst was lined by squamous epithelium (B, H&E, ×200). Squamous epithelium was positive for p63 (C, ×200) and negative for thyroglobulin and thyroid-associated transcription factor-1 (D, ×200).

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