Thyroglossal duct papillary carcinoma presenting as submental neck node

Abstract

Neck node in sub mental area is not uncommon. It occurs mostly due to infective or malignant pathologies in oral cavity. Submental neck node mass due to thyroglossal duct cyst carcinoma is a rare presentation. A 25 year old female presented with a sub mental neck node which was noticed for 6 weeks with no history of fever or any oral lesions. On examination, there was a 1 × 1 cm non tender, firm, mobile sub mental neck node. Fine Needle aspiration cytology (FNAC) of the submental node showed features of metastatic papillary carcinoma from thyroid. Whole body Technitium 99 Pertechnate scan was done to find the primary site and metastases in other neck nodes but failed to find any. After necessary investigations, Total thyroidectomy with sistrunk’s procedure, central compartment clearance and level I clearance, was done.  Histopathology report showed papillary carcinoma arising from Thyroglossal duct with metastases in submental lymph node. Different pathologies of a mass occurring in submental area are reactive lymphoid hyperplasia, non-Hodgkin lymphoma, dermoid cyst, abscess, sarcoidosis, hemangioma, and lipoma. Neck mass in submental area occurring due to metastases from thyroglossal duct cyst carcinoma without the swelling in primary is a rare presentation.