Thyroglossal Cysts

Question 1

Define Thyroglossal Cyst?

Answer 1

An epithelium-lined cyst found along the course of descent of the thyroid gland

Question 2

What is the aetiology of Thyroglossal Cysts?

Answer 2

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

Question 3

What is a risk factor for Thyroglossal Cysts?

Answer 3

Rare Familial Variants

Question 4

What is the epidemiology of Thyroglossal Cysts?

Answer 4

Present in CHILDREN and ADOLESCENTS
Mean age of presentation: 5 yrs
3 x more common than branchial cysts

Question 5

What are the presenting symptoms of Thyroglossal Cysts?

Answer 5

A swelling/lump is noticed in the midline of the anterior neck
Usually asymptomatic
May be tenderness or rapid enlargement due to infection

Question 6

What are the signs of Thyroglossal Cysts on physical examination?

Answer 6

Midline, smooth, rounded swelling
Typically found between the thyroid notch and the hyoid bone
Moves upwards on protrusion of the tongue
Moves upwards with swallowing
Can be transilluminated

Question 7

What are the differential diagnoses based on some of the signs of Thyroglossal Cysts on physical examination?

Answer 7

Lymph Node
Dermoid Cyst
Ectopic Thyroid Tissue

Question 8

What investigations might you do for Thyroglossal Cysts?

Answer 8

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
US / MRI

Question 9

Why do we do US/MRI for Thyroglossal Cysts?

Answer 9

Helps differentiate from other structures