Click the arrow to see the next slide with the correct interpretation.
Thyroglossal Duct Cyst Presenting as Localized Neck Swelling
A patient with localized neck swelling is found to have a thyroglossal duct cyst.
Imaging overview:
Sagittal, axial, and coronal contrast-enhanced CT shows a round, low-attenuation mass in the anterior midline neck. On the sagittal view, the mass lies in the suprahyoid neck at the level of the hyoid bone. The axial and coronal images show the mass as a well-defined midline structure.
Clinical insight:
A thyroglossal duct cyst is the most common congenital neck lesion. It arises from remnants of the thyroglossal duct along the path of thyroid descent. Classically, it is a midline cystic mass at or above the hyoid bone, although it can be off midline or within the infrahyoid neck, embedded in the strap muscles. An enhancing component or calcification raises concern for associated thyroid carcinoma. Imaging should also confirm a normal thyroid gland in its usual position before surgical planning.
Case courtesy of Justin Kerby, MD, University of Iowa Hospitals & Clinics.