Thyroglossal Duct Cyst

A thyroglossal duct cyst is a lump in the neck that may appear after the formation of the thyroid gland during embryonic development. It is usually diagnosed in preschool-aged children or during mid-adolescence.

Symptoms of a Thyroglossal Duct Cyst

Although each child may experience symptoms differently, common signs of a thyroglossal duct cyst may include:

• A small, soft, round mass in the center front of the neck
• Tenderness, redness, and swelling of the mass, if infected
• A small opening in the skin near the mass, with drainage of mucus from the cyst
• Difficulty swallowing or breathing

The symptoms of a thyroglossal duct cyst may resemble other neck masses or medical problems. Always consult your child's doctor for a diagnosis.

Causes of a Thyroglossal Duct Cyst

A thyroglossal duct cyst is a congenital defect (present from birth). When the thyroid gland
forms during embryonic development, it begins at the base of the tongue and moves down the neck through a canal called the thyroglossal duct. This duct normally disappears once the thyroid reaches its final position. Sometimes, portions of the duct remain, leaving pockets called cysts.

These cysts can fill with fluid or mucus and may enlarge if they become infected. Very enlarged cysts can cause difficulty swallowing or obstruct breathing passages. A thyroglossal duct cyst often appears after an upper respiratory infection when it enlarges and becomes painful.

Diagnosing a Thyroglossal Duct Cyst

Generally, a diagnosis is made by physical examination. The mass typically moves up when the tongue is extended and with swallowing since the duct often connects at the base of the tongue. It is important to determine if the thyroglossal duct cyst contains thyroid tissue.

In addition to a physical exam and medical history, diagnostic procedures for a thyroglossal duct cyst may include:

• Blood tests: These tests check thyroid function.
• Ultrasound: This imaging test uses sound waves to see the mass and surrounding tissues.
• Thyroid scans: This procedure uses radioactive iodine or technetium (a radioactive metallic element) to reveal any physical abnormalities of the thyroid.
• Fine needle aspiration: This procedure removes cells from the cyst for diagnosis. 

Treatments for a Thyroglossal Duct Cyst

Your doctor will work with you to determine your child’s best treatment plan, based on factors such as age, overall health, medical history, the extent of the condition, and your child’s tolerance for certain medications or procedures.

While your doctor may prescribe antibiotics to treat an infected cyst, surgical removal of the cyst and thyroglossal duct—called the Sistrunk procedure—is often recommended. A thyroglossal duct cyst has a small chance of regrowing if a portion of the tissues remains after surgery. Infection of the cyst prior to surgery can make the removal more difficult and increase the chance for regrowth.

Why Choose Columbia

Our team of highly trained specialists will work with you to decide which type of treatment best fits your needs based on how often and how severely your child’s thyroglossal duct cyst gets infected. If surgery is necessary, our surgical team will provide the best care possible and guide you and your child through a safe recovery.