Abstract

Thyroglossal duct cyst carcinoma (TDCC) presents a clinical challenge, as the condition's prevalence might lead to the risk of unnecessary thyroidectomy surgeries. This review aimed to identify the rationale for thyroidectomy in TDCC patients by examining specific clinical indications that might warrant additional surgical intervention. Following PRISMA guidelines, four databases were searched through January 2025. The main variables of interest were carcinoma size ≥ 1 cm, presence of thyroid nodules, concomitant thyroid carcinoma, invasive TDCC, BRAFV600E mutation, lymph node involvement or metastasis, and local recurrence of TDCC. A 95% confidence interval (CI) and a random-effects model were applied to estimate the metric proportions for each variable. A total of 32 studies that investigated patients with TDCC who underwent thyroidectomy were included. It was found that 81% of patients presented with tumor sizes ≥10 mm, 65% had thyroid nodules, and 52% showed concomitant thyroid carcinoma. Invasive TDCC was observed in 47% of patients, while lymph node involvement or metastasis was reported in 35%. BRAFV600E mutations were found in 44% of patients. Local recurrence after thyroidectomy was estimated at 7%. Only half of TDCC patients had concomitant thyroid carcinoma, indicating that thyroidectomy should not be standardized in all cases. It was identified that tumor size ≥1 cm and thyroid nodules, among other indications, as common indications necessitating thyroidectomy in TDCC. The ongoing debate regarding TDCC’s origin, whether de novo or metastatic, highlighted the need for individualized surgical strategies.

Key words: TDCC, rationale, thyroidectomy, meta-analysis, systematic review.