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Joseph Junewick, MD FACR
over 6 years ago
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Thyroglossal duct cyst

Case Detail

Anatomy: Neck-Face
Junewick
Joseph Junewick, MD FACR
Diagnostic Category:
Created: over 8 years ago
Updated: over 8 years ago
Tags: PEDS
Modality/Study Types: US CT
Activities:
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History

Child with neck mass.


Case Images


Diagnosis

Thyroglossal duct cyst

Findings

US – Thin walled cystic mass with uniform low-level echoes contiguous with the thyroid gland.

CT – Nonenhancing midline mass extending from the thryroid gland to the submandibular region measuring 14 Hounsfield units.

Discussion

Thyroglossal duct cyst (TDC) is the most common congenital neck mass and account for 2-4% of all neck masses. Embryologically, the thyroid descends from the base of the tongue into the neck, leaving an epithelial tract. If the tract does not obliterate, a cyst will form. The cyst is usually lined by squamous or respiratory epithelium but can have islands of thyroid tissue. Cyst secretions are often thick and mucinous leading to low level echoes on sonography.

TDC most often present in childhood as a non-tender mobile mass. The mass may acutely enlarge after illness because of secondary infection. Occasionally TDC can cause airway obstruction.

The 2 most common types of TDC are suprahyoid and infrahyoid. Suprahyoid cysts are midline; infrahyoid cysts are paramedian. Since the cyst is connected to the foramen cecum, the cyst will move with protrusion of the tongue. Surgical resection of the mass to the base of the tongue and resectrion of the midline hyoid bone minimizes recurrence.

Reference

Kutuya N and Kurosaki Y. Sonographic Assessment of Thyroglossal Duct Cysts in Children. J Ultrasound Med (2008); 27:1211-1219.



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