A 21-year-old lady was admitted with a one year history of painless swelling in the neck. The clinical features and radiological findings suggested a thyroglossal duct cyst. Histology of the excised duct cyst showed papillary carcinoma. Ultrasound examination of the thyroid gland was normal. The patient is on regular follow-up and is well two years following surgery.
Thyroglossal duct cyst is the most common upper neck midline lesion in children. Approximately 1% of
thyroglossal duct cyst undergoes malignant transformation. Calcification which is a marker of malignancy
almost always points out to papillary thyroid carcinoma. Benign case of calcified thyroglossal cyst maybe
undiagnosed or under reported. We report a case of a 5 year old girl with a benign calcified thyroglossal
duct cyst, a fourth case in world literature. Here the differences between a benign and malignant
thyroglossal duct cyst are discussed.
Thyroglossal duct cyst (TDC) is a developmental anomaly that usually appears in early childhood. The common presentation is midline swelling of the neck, which moves with both tongue protrusion and deglutition. Diagnosis is usually clinical and radiological. Fine needle aspiration cytology (FNAC) can be used as a tool for the exclusion of malignancy in adult patients. In some cases thyroid scan is done to rule out the presence or absence of the normal thyroid gland. A complete work-up is mandatory before cyst removal given that it contains only thyroid tissue. We report the case of a 32-year-old woman with only thyroid tissue in thyroglossal duct cyst.
Patients with anterior neck masses commonly present to otorhinolaryngology clinics, but there are limited differential diagnoses for such lesions. Common ones include thyroid nodule and thyroglossal duct cyst. In an elderly patient, a differentiated thyroid carcinoma should be suspected especially if it moves with swallowing. We encountered a typical presentation of a solitary thyroid nodule-like mass with the exception of pulsation in a 65-year-old female. Further investigation, using neck ultrasonography, revealed that it was a variant of right common carotid artery arising from the left common carotid artery. Knowledge of such variants is of great importance as ignorance of such a variation may lead to inadvertent surgical complications during procedures.