Thyroglossal Cyst

Aka: Thyroglossal Cyst, Thyroglossal Duct Cyst, Thyroglossal Fistula

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II. Epidemiology

  1. Incidence: 7%
  2. Most commonly presents in childhood

III. Pathophysiology

  1. Residual vestigial tract from fetal development
    1. Tract left by descending Thyroid during Embryogenesis
    2. Tract courses from Tongue base to anterior neck

IV. Signs

  1. Cystic mass at midline of neck adjacent to Hyoid Bone
    1. Increases in size after Upper Respiratory Infection
  2. Mass moves upward (vertically) on:
    1. Swallowing
    2. Protruding Tongue

V. Complications

  1. Cyst infection (follows Upper Respiratory Infection)
  2. Papillary carcinoma (in adults)

VI. Differential Diagnosis

  1. See Neck Masses in Children
  2. See Neck Masses in Adults
  3. Undescended Lingual Thyroid (as high as 1-2%)

VII. Radiology: Confirms normal Thyroid separate from cyst

  1. Radionuclide Thyroid Scan or
  2. Neck Ultrasound

VIII. Management

  1. Surgical excision of cyst, tract (Sistrunk Procedure)

IX. References

  1. Townsend (2001) Sabiston Surgery, Saunders, p. 546
  2. Ewing (1999) Eur Arch Otorhinolaryngol 256(3):136-8 [PubMed]
  3. Gupta (2001) Arch Otolaryngol Head Neck Surg 127:200-2 [PubMed]

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