Presentation
Large, midline, chronic, non-tender, neck mass. Now increasing in size.
Patient Data
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A large, midline, unilocular cyst with complex intracystic contents, at the level of the thyroid gland. The cyst splays the strap muscles. There is no associated duct identified sonographically. The thyroid gland is normal.
There are benign reactive lymph nodes present.
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There is a large, unilocular, midline, thin-walled, infrahyoid cyst at the level of the thyroid gland. There is splaying of the strap muscles. There is minimal wall enhancement. The cyst measured 20-30 Hu. There is no associated duct identified.
Case Discussion
The features appear appropriate for a thyroglossal duct cyst on imaging. At the time of surgical excision, the cyst was removed intact and no associated duct was present. Histopathology confirmed a dermoid cyst with the absence of thyroid parenchyma.
Dermoid/ epidermoid cysts represent one of the differential diagnoses for midline neck masses.