A thyroglossal duct cyst is a condition where there is development of neck lump or mass from the leftover or persistent tissues and cells present after the formation of the thyroid gland. This happens during the embryonic (developmental) stage.
Thyroglossal duct cyst is often diagnosed in children who are preschool-aged or in children who are in their mid-adolescence. Thyroglossal duct cyst commonly appears after an upper respiratory infection after which it increases in size and causes pain and other symptoms which often leads to its diagnosis.
Causes of Thyroglossal Duct Cyst
A thyroglossal duct cyst develops congenitally, i.e. this defect is present from the birth of the child itself. When there is formation of thyroid gland during the embryonic stage, it starts at the floor of the tongue and travels down the neck via a canal known as thyroglossal duct. When the thyroid reaches its final stage in its formation, this duct disappears.
In some cases, there are portions of the duct remaining which leave behind pockets or cavities which are known as the thyroglossal duct cysts. There can be accumulation of mucus or fluid in these thyroglossal duct cysts which leads to increase in their size and becoming infected. If the size of the thyroglossal duct cyst is very large, then it can cause problems with swallowing and block the breathing passages of the patient.
Signs & Symptoms Thyroglossal Duct Cyst
The symptoms of the thyroglossal duct cyst are similar to other medical conditions and neck masses. So, it is important to make an accurate diagnosis and treat thyroglossal duct cyst accordingly. The following are the common symptoms seen in a patient with Thyroglossal Duct Cyst:
- Patient suffering from thyroglossal duct cyst would have symptoms of a small, soft round mass in the middle front of his/her neck where the hyoid bone is located. This mass can be felt with fingers.
- Patient suffering from thyroglossal duct cyst would have symptoms of redness, tenderness and swelling in the mass, if it is infected. Otherwise, the mass can remain painless and smooth.
- There can be a small opening in the skin adjacent to the mass where the mucus gets drained from the cyst.
- The patient experiences symptoms of difficulty in breathing or swallowing.
- Thyroglossal duct cyst patient can also have symptoms of pain in the upper abdomen.
Diagnosis of Thyroglossal Duct Cyst
Physical examination usually helps in making the diagnosis of thyroglossal duct cyst. When the tongue is extended and when the patient swallows, the neck mass usually moves in an upward direction, as the thyroglossal duct is usually connected at the base of the tongue. Determining whether the thyroglossal duct cyst consists of thyroid tissues is important.
Other than medical history and physical examination, investigations which are undertaken for diagnosis of thyroglossal duct cyst are:
- Blood tests are done to check the thyroid function.
- CT scan and ultrasound of the neck is done where a computer and high-frequency sound waves are used to generate images of tissues, blood vessels and organs to look at the muscle surrounding the mass more clearly. Ultrasound also helps in assessing blood circulation through the different vessels and the function of the internal organs.
- Thyroid scan is a diagnostic procedure done, which uses radioactive iodine or technetium to look for any physical abnormalities in thethyroid gland.
- Fine needle aspiration is a procedure, which removes cells present in the thyroglossal duct cyst for further testing and diagnosis.
Treatment of Thyroglossal Duct Cyst
The treatment of thyroglossal duct cyst depends on the following factors:
- Patient’s age, medical history and general health.
- The extent of the condition, i.e. the thyroglossal duct cyst is also an important consideration when it comes to its treatment.
- Patient’s tolerance for certain medications and therapies/procedures.
- The prognosis of the condition.