Thyroglossal duct cyst
Right sided neck swelling
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A well defined cystic lesion is noted at the right side of the neck with thin wall and clear watery content. It is located deep to platysma and intimately deep to right strap muscles which is stretched anteriorly by the cyst. It directly lies over the right lamina of thyroid cartilage stretching and displacing the right strap muscles anteriorly. It extends postero-laterally in between the anterior border of right sterno-mastoid muscle and right submandibular gland to be intimately related to right external jugular vein. Its superio-medial part directly related to inferior and interior aspects of the right side of the hyoid bone till near midline.
This case represents a cystic lesion at the right side of the neck with the superiomedial part curves behind the hyoid bone. As this corresponds to the course of thyroglossal duct, thyroglossal duct cyst was regarded as first consideration. Thyroglossal duct cyst can grow off midline and can have less common more lateral extensions such as extension along the anterior border of the sternocleidomastoid presenting as lateral neck swelling as in this case. So, it should be well differentiated from second branchial cleft cyst. Thyroglossal duct cyst should be considered as a differential diagnosis in any cystic neck swelling.