Lingual thyroglossal duct cyst

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Cystic mass discovered incidentally on ENT exam.

Patient Data

Age: 4 years
Gender: Female
ultrasound

Well-defined cystic lesion with homogeneous content at the base of the tongue.

Normal appearance of the thyroid gland.

Well-defined ovoid cystic lesion at the base of the tongue measuring 18 x 16 x 12 mm of homogeneous content of low signal on T1, high signal on T2 with no restricted diffusion, and peripheral regular enhancement on post-contrast sequences.

Case Discussion

Thyroglossal duct cysts (TGDC) are the most common type of congenital neck cysts and pediatric neck masses (90% before the age of 10 years). Typically seen as a painless rounded midline anterior neck swelling or if infected, as a red warm painful lump.

The cysts can occur anywhere along the course of the thyroglossal duct from the foramen cecum to the thyroid gland although infrahyoid location is most common.

They can be diagnosed with multiple imaging modalities including ultrasound, CT and MRI.

Associated ectopic thyroid in ~40% of cases.

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