Thyroglossal Cyst

THYROGLOSSAL CYST
  • It is congenital in origin.
  • It is cystic swelling developed in the remnant of the thyroglossal duct or tract.
CLINICAL FEATURES OF THYROGLOSSAL CYST
  • Site - It may be present in any part of the thyroglossal tract (thyroglossal tract extends from foramen caecum to the isthmus of thyroid).
  1. Hyoid bone is closely associated with Thyroglossal cyst/fistula.
  2. Common sites are:
  3. Subhyoid (most common) in the region of the thyroid cartilages,
  • Suprahyoid in the floor of mouth
  • Beneath the foramen caecum
  • It is a painless midline swelling, except in the region of the thyroid cartilage, where the thyroglossal tract is pushed to one side, usually to the left.
  • It is located within 2 cm of the midline
  • . Though its a congenital swelling most common age of presentation is between 2 to 4 yrs.
  • Mobility - Cyst can be moved sideways but not vertically
  • Peculiar characterstic which helps in distinguishing thyroglossal cyst from other neck swelling - it moves up with protrusion of tongue as the thyroglossal tract is attached to the tongue.
  • It also moves with deglutition so do all thyroid swellings, subhyoid bursitis, sublingual dermoid.

  • Cyst is lined by pseudostratified columnar epithelium and squamous epithelium with hetrotopic thyroid tissue present in 20% of cases..
COMPLICATIONS OF THYROGLOSSAL CYST
  • Recurrent infection
  • Formation of thyroglossal fistula.
  • Thyroglossal cyst is congenital but thyroglossal fistula is never congenital. It follows infection or inadequate removal of a thyroglossal cyst.
  • Carcinomatous change (usually Papillary carcinoma.)
TREATMENT OF THROGOLSSAL CYST
  • Excision of the thyroglossal cyst along with the track and the central part of body of the hyoid bone is the treatment of choice (Sistrunk’s operation)
Exam Question
  • Most common site of thyroglossal cyst is Subhyoid.
  • Thyroglossal cyst moves upwards on protrusion of tongue.
  • Thyroglossal cyst is located within 2 cm of the midline.
  • Thyroglossal cyst is the frequent cause of anterior midline neck masses in the first decade of life.
  • Excision of the thyroglossal cyst along with the track and the body of the hyoid bone is the treatment of choice (Sistrunk’s operation)
  • The most common site of a swelling in a 16 year old girl presenting with a painless swelling in the midline of the neck and moves up and down with swallowing and with 
  • protrusion of the tongue is Subhyoid.
  • The cause of swelling in a child presenting with a midline swelling beneath the arch of the hyoid bone might be Thyroglossal cyst.
  • In thyroglossal cyst, Papillary carcinoma may arise.
  • Thyroglossal cyst is an example of painless midline swelling.
  • Hyoid bone is closely associated with Thyroglossal cyst/fistula.
  • In the management of thyroglossal cyst,Central portion of hyoid excised.
  • Sistrunk's operation is used in Thyroglossal fistula and Thyroglossal cyst.
  • Thyroglossal cyst move on deglutition(other causes are pre-tracheal lymph nose and thyroid nodule)
  • Thyroglossal fistula develops due to Incomplete removal or infection of thyroglossal cyst

Don't Forget to Solve all the previous Year Question asked on Thyroglossal Cyst