What’s a thyroglossal cyst?

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A thyroglossal cyst is a mass on the neck caused by a congenital defect of the thyroglossal duct. Small cysts may not require treatment, but larger or infected cysts may need surgery. Diagnosis is made through physical exam, ultrasound, and tissue analysis. Treatment options include antibiotics and surgery.

A thyroglossal cyst is an abnormal mass that appears on the front of the neck, usually midway between the chin and upper chest. It results from a congenital defect of the thyroglossal duct, the embryonic precursor of the thyroid gland. A cyst may be evident shortly after birth or take several years to grow large enough to be apparent. Small asymptomatic masses typically don’t require immediate treatment, but a large, growing, or infected thyroglossal cyst may need to be surgically removed to relieve symptoms and prevent health complications.

During early embryonic development, the thyroid gland begins to form near the base of the tongue. A temporary channel called the thyroglossal duct helps move the thyroid down the neck to its permanent position. In normal development, the duct evolves, or folds back on itself, after descent of the thyroid gland. A thyroglossal cyst develops if the duct does not evolve properly and the remnants of thyroid tissue become trapped in the neck.

A very small thyroglossal cyst may never cause any noticeable symptoms or health problems. Larger cysts, which can be about a half inch (about 1.25 centimeters) in diameter or larger, often cause difficulty swallowing or breathing. If a cyst becomes infected, an individual can experience a variety of unpleasant symptoms. The lump may become tender, red, and swollen with infection, and pus may drain into the throat or through a break in the inflamed skin. It’s important to visit a pediatrician or the emergency room as soon as possible when a child shows signs of an infected thyroglossal cyst.

A doctor can usually diagnose a thyroglossal cyst with a careful physical exam. He or she might conduct an ultrasound or computed tomography scan to study the thyroid gland and confirm the presence of thyroglossal duct tissue in the throat. Blood and tissue samples are taken and analyzed in a clinical laboratory to make sure the cyst isn’t cancerous or the result of a more serious medical condition. Once a diagnosis is made, treatment options can be considered.

Infected cysts are usually treated with oral antibiotics. If the skin over a cyst is broken, a patient may need to apply topical antibiotics as well to promote faster healing. Surgery is usually needed for large cysts that cause breathing problems or become infected frequently. A surgical specialist can make a small incision in the neck, drain the pus and excess fluid, and remove the entire lump. The procedure has a high success rate, and most patients don’t have long-term or recurring thyroid problems.

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