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Neck Cysts (Pediatric)

What are neck cysts?

Neck cysts are a common problem for infants and children, are usually benign masses, and may be present at birth. Common types are:

Branchial cleft abnormalities: These tissues may form cysts (pockets that contain fluid) or fistulas (passages that drain to an opening in the skin surface). They are usually located near the front edge of the neck muscle that goes from the jawbone across to the collarbone and breastbone.

Thyroglossal duct cysts: These neck masses or lumps develop from cells and tissues remaining after the formation of the thyroid gland during embryonic development. This type of cyst tends to be diagnosed in preschool-aged children or in mid-adolescence and often appears after an upper respiratory infection, when it enlarges and becomes painful.

What causes neck cysts?

Branchial cleft abnormalities and thyroglossal duct cysts develop during early embryonic development, when the structures and tissues that form the neck and throat do not properly form.

What are the symptoms of neck cysts?

The main symptom of a branchial cleft abnormality is a small, painless lump or mass near the front edge of the neck muscles. It usually occurs only on one side of the neck but may be bilateral (rarely on both sides). If the lump or mass becomes infected, it may turn red, hot, and tender. It may also drain mucus or fluid from a small opening in the skin.

The main symptom of a thyroglossal duct cyst is a small, soft, round mass in the center front of the neck. If infected, the mass may turn red, hot, and tender. It may also drain mucus or fluid from a small opening in the skin. Children often have difficulty swallowing or breathing.

How are neck cysts diagnosed?

Branchial cleft abnormalities and thyroglossal duct cysts are generally diagnosed by:

  • Physical exam
  • Blood tests to assess thyroid function.
  • Ultrasound examination that uses high frequency sound waves and a computer to create images of the mass and surrounding tissues.
  • Thyroid scans that use radioactive iodine or technetium (radioactive metallic element) to show physical abnormalities of the thyroid.
  • Fine needle aspiration to remove cells from the cyst for evaluation.
  • Biopsy in which tissue samples are removed for examination under a microscope.

What is the treatment for neck cysts? 

  • Surgery 
  • Antibiotics for infections

Our pediatric surgeons determine treatment based on each child’s age, overall health, and medical history as well as:

  • Extent of the condition
  • Tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Parents’ opinion or preference