A man who had been living with a large lump on his neck for more than decade finally sought to remove it but received a surprising cancer diagnosis, despite never having any symptoms.
Around age 31, an anonymous Polish man noticed a small, firm, painless lump in the front of his neck.
He went about his life, working in a military museum as a night guard, but the lump continued to grow. After 15 years, he noticed the mass had gotten large enough that it was getting in the way of him shaving.
Eventually, he went to the Military Institute of Aviation Medicine hospital in Warsaw.
There, doctors discovered the man had a neck mass nearly 2inches in size – about the size of a stamp. They assumed it was a harmless growth called a Thyroglossal duct cyst (TGDC) that usually forms in the womb.
However, testing later revealed he was among just one percent of patients with this growth who had cancerous cells within otherwise normal tissue. The patient was then diagnosed with thyroid cancer.
Researchers from the Military Institute of Aviation Medicine are raising awareness about this rare condition. Given the unusual presentation of the cancer, said doctors should be on the look out for it, especially in their elderly patients.
The majority of these cysts are found in children under age ten. In this case study, the man didn’t notice the growth until his thirties
TGDC is a relatively common neck abnormality, and is found in 70 percent of children with neck lumps. As people age, they become less common, and only affect an estimated seven percent of Americans per year.
These form in the womb, when genetic abnormalities cause leftover thyroid tissue to form into pockets that fill with fluid.
There, TGDCs can go undetected for years.
Usually, someone figures out they have one when they notice subtle swelling along the front of their neck, or develop problems swallowing or keeping their tongue in their mouth.
This is most commonly diagnosed in children before age 10, according to Cleveland Clinic.
Most patients experience no pain, and the vast majority of these are harmless – but in about one percent of cases, they contain cancerous cells that can spread.
In the Polish man’s situation, doctors say it is unusual for someone to live to age 30 and not realize they have this kind of growth.
That was the case of the anonymous 46-year-old man, whose story was published in the American Journal of Case Reports.
After taking initial scans, doctors predicted he had TGDC, but not cancer. Still, to stop the lump from growing and making the man uncomfortable, they opted to remove it with surgery. It’s unclear when this occurred.
The surgery, they wrote, was uneventful. They were able to remove the entire growth and the man only took two days of recovery at the hospital. Later though, routine cellular testing discovered a cluster of cancerous cells within the lump.
The arrow shows the lump in the throat of the 46-year-old patient. Doctors moved to cut it out before they suspected he might have cancer
He was diagnosed with primary papillary thyroid cancer. Luckily, doctors caught it in while it was still a Stage 1 cancer, before it had grown even larger or spread into the patient’s bones, blood or lymph nodes.
After performing further tests to ensure it hadn’t spread, the doctors concluded the patient’s cancer had already been cut out. Six months later, he was still cancer free.
In the rare cases where this kind of neck bump is cancerous, the best form of treatment is surgery, the study authors said. This sometimes means people also have to get part of their thyroid or neck bones removed.
On top of surgery, people with this kind of thyroid cancer, which affects about 44,000 Americans per year, may also benefit from hormone therapy, radiation or chemotherapy.
If caught early, like in the case study, this type of cancer is incredibly treatable. Between 99 and 100 percent of patients with the condition are declared cancer-free five years after being diagnosed and treated.
Though it’s rare for these kinds of cysts to turn into cancerous tumors, the researchers from the case study recommend doctors who find these in people over 40 take special precaution to look for cancer.
They said: ‘Suspicion of malignancy should be heightened in elderly patients with a TGDC, due to the rarity of this condition in that age group.’
