Thyroglossal cyst

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A thyroglossal cyst is a fibrous cyst that forms from a persistent thyroglossal duct.

It usually presents as a midline neck lump, which is painful if infected. There may be difficulty breathing, dysphagia (difficulty swallowing), and/or dyspepsia (discomfort in the upper abdomen), especially if the lump becomes large.

The most common locations for a thyroglossal cyst is midline or slightly off midline, between the isthmus of the thyroid and the hyoid bone or just above the hyoid bone. A thyroglossal cyst can develop anywhere along a thyroglossal duct, though cysts within the tongue or in the floor of the mouth are rare.

A thyroglossal cyst will move upwards with protrusion of the tongue.

Thyroglossal cysts are associated with an increased incidence of ectopic thyroid tissue. Occasionally, a lingual thyroid can be seen as a flattened strawberry-like lump at the base of the tongue.

Very rarely, the persistent duct can become cancerous, called thyroglossal duct carcinoma. In the case of thyroglossal duct carcinoma, the cancerous cells are ectopic thyroid tissue that has been deposited along the thyroglossal duct and usually follows exposure to radiation.

The thyroglossal tract arises from the foramen caecum at the junction of the anterior two-thirds and posterior one-third of the tongue. Any part of the tract can persist causing a sinus, fistula or cyst. Most fistulae are acquired following rupture or incision of the infected thyroglossal cyst.

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