Thyroglossal Cyst

“Fibrous cyst in the neck that arises from a persistent thyroglossal duct”

Risk Factors

• Not typically associated with any additional congenital abnormalities

Aetiology

• Congenital abnormality

Pathophysiology

• Persistence of part of the thyroglossal duct (an embryological remnant of thyroid gland development, should completely disappear) provides a reservoir for the collection of fluid/mucus and can lead to the development of a cyst.

Clinical Presentation

• Cysts are usually found in the midline of the neck
• They are usually small, mobile, soft, non-tender and fluctuant
• They move up and down with the movement of the tongue
• The patient may also experience difficulty breathing or swallowing
• This cyst is present from birth but is usually not diagnosed until childhood

Investigations

• TFTs to check thyroid function
• CT / USS +/- fine needle aspiration can be used to confirm the diagnosis

Management

• Surgical resection (commonly the Sistrunk procedure)
• +/- antibiotics

Complications

• Infection, thyroglossal fistula, thyroglossal duct carcinoma (rare)
• Cysts can reoccur if any of the thyroglossal duct remains after surgery