Obstructive sleep apnoea in a case of thyroglossal duct cyst carcinoma

Abstract Objectives: To report a rare case of thyroglossal duct cyst carcinoma which presented with obstructive sleep apnoea, and to highlight the difficulties in making this clinical diagnosis. Method: Case report and review of the English language literature concerning thyroglossal duct cyst carcinoma. Results: Thyroglossal duct cyst carcinoma is a rare clinical entity found in only approximately 1 per cent of all patients operated upon for thyroglossal duct cyst. This condition usually presents in an identical manner to its benign counterpart; atypical presentations have not previously been reported. Our patient is the first reported case of a thyroglossal duct cyst carcinoma first presenting with symptoms of obstructive sleep apnoea, without a neck mass. Complete surgical excision with total thyroidectomy and lymph node clearance was performed, in view of the positive lymph node metastases (seen on imaging) and the need for post-operative radioiodine therapy. Conclusion: Thyroglossal duct cyst carcinomas may present atypically, posing a diagnostic dilemma for the clinician. For patients diagnosed with obstructive sleep apnoea, it is imperative that a thorough otolaryngological examination be performed to exclude any underlying pathology.