# Case Report: Endoscopic Sistrunk and thyroidectomy via the areola approach in patients with thyroglossal duct cysts and thyroid cancer

## TL;DR

A new endoscopic surgical method via the areola is used to treat both thyroglossal duct cysts and thyroid cancer, avoiding neck scars.

## Contribution

This is the first report of simultaneous endoscopic treatment of thyroglossal duct cyst and papillary thyroid cancer via the areola approach.

## Key findings

- The patient recovered well and was discharged on the second day after surgery.
- Endoscopic resection and thyroidectomy via the areola approach is effective and scar-free for treating both conditions.

## Abstract

Thyroglossal duct cyst (TGDC) is the most prevalent congenital cervical anomaly. As the standard of care, Sistrunk operation via transverse cervicotomy is used to surgically treat TGDC. Over the last four decades, prevalence of thyroid cancer has increased, making it the most common endocrine malignancy worldwide. The standard surgical method is open thyroidectomy, which is typically conducted through a cervical incision. However, the co-occurrence of TGDC and thyroid cancer is extremely rare, and there are currently no standard clinical guidelines for managing both conditions simultaneously. Endoscopic approaches have become increasingly popular for neck surgery because of improved postoperative aesthetics and recent advances in endoscopic methods. We therefore report a novel technique for endoscopic Sistrunk surgery and thyroidectomy via the areola approach in a 24-year-old female patient with both TGDC and papillary thyroid cancer (PTC). The patient recovered well and was discharged on the second day after surgery. To our knowledge, this is the first report of simultaneous endoscopic treatment of TGDC and PTC via the areola approach. Our results demonstrate that endoscopic resection and thyroidectomy via the areola approach is an effective surgical modality and a viable alternative for the complete removal of TGDC and PTC without neck scarring, especially for young patients who wish to obtain better cosmetic results.