Thyroglossal cysts

Question 1

What is a Thyroglossal cyst?

Answer 1

Epithelium-lined fluid-filled sac along the course of descent of the thyroid, resulting from incomplete closure of the thyroid’s migration path

Question 2

Describe the aetiology of Thyroglossal cysts

Answer 2

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
Normally disappears in the 6th week, but if some tissue remains, it can develop into a cyst

Question 3

Give a risk factor for Thyroglossal cysts

Answer 3

RARE familial variants

Question 4

Describe the epidemiology of Thyroglossal cysts

Answer 4

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

Question 5

Describe presentation of Thyroglossal cysts

Answer 5

Noticeable swelling/ lump in the midline of the anterior neck
Usually ASYMPTOMATIC
May be tenderness or rapid enlargement due to infection
 

Question 6

Describe the appearance of Thyroglossal cysts

Answer 6

Midline, smooth, rounded swelling

Typically between the thyroid notch + hyoid bone

Question 7

Give 3 features of Thyroglossal cysts on examination

Answer 7

Moves upwards on protrusion of the tongue
Moves upwards with swallowing
Can be transilluminated (contains clear fluid so glows)

Question 8

Give 3 differentials for Thyroglossal cysts

Answer 8

Lymph node
Dermoid cyst
Ectopic thyroid tissue

Question 9

What investigations are needed for Thyroglossal cysts?

Answer 9

NONE if patient is euthyroid

US/ MRI: to differentiate from other structures

Question 10

What investigations may be performed if the cyst is supra hyoid?

Answer 10

TFTs: to exclude a lingual thyroid; because removal of the lingual thyroid will make the patient hypothyroid