Thyroglossal cyst Flashcards
Define thyroglossal cyst?
An epithelium-lined fluid-filled sac found along the course of descent of the thyroid gland, resulting from incomplete closure of the thyroid’s migration path
Basics when the thyroid gland descends there is a duct which forms and is meant to disappear but sometimes it doesn’t and forms a sac
outline the aetiology/ risk factors of thyroglossal cysts?
The thyroglossal duct is an embryonic remnant of the path of descent of the thyroid gland from the mouth down to its normal position during development
The duct normally disappears in the 6th week, but if some tissue remains, it could develop into a cyst
Risk Factors- RARE familial variants
summarise the epidemiology of thyroglossal cysts?
Presents in CHILDRENand ADOLESCENTS
Mean age of presentation: 5 yrs
3 x more common than branchial cysts
what are the symptoms of thyrpglossal cysts?
A swelling/lump is noticed in the midlineof the anterior neck
Usually ASYMPTOMATIC
May be tenderness or rapid enlargement due to infection
what are the signs of a thyroglossal cyst on physical examination?
Midline, smooth, rounded swelling
Typically found between the thyroid notch and the hyoid bone
Moves upwards on protrusion of the tongue (foramen caecum connection)
Moves upwards with swallowing
Can be transilluminated– using a pen torch, a light in shone across the lump. A swelling containing clear fluid will glow, whereas solid mass will not.
what are the differentials for a thyroglossal cyst?
Lymph node
Dermoid cyst
Ectopic thyroid tissue
Chondroma (benign cartilaginous mass) – bony hard
If age >20, probably thyroid isthmus mass.
what are the investigations for a thyroglossal cyst?
NONE may be necessary if the patient is euthyroid
If the cyst is suprahyoid, TFTs should be performed to exclude a lingual thyroid - because removal of the lingual thyroid will make the patient hypothyroid
Ultrasound/MRI
Helps differentiate from other structures
