Clinical Capsule

MBBS
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12 yera old comes with a midline swelling in neck that moves on deglutition. The swelling is painless and located just below the hyoid bone. No signs of infection are noted. Thyroid function tests are normal.

  1. What is the most likely diagnosis?
  2. What investigations will you do to confirm your diagnosis?
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Do FNAC of the swelling and diagnose correlating with the clinical features

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It may be Thyroglossal Duct Cyst (TGDC)

To confirm do Investigations:

  1. Ultrasound neck – to confirm cyst and locate normal thyroid.
  2. Thyroid scan (Scintigraphy) – if thyroid location is unclear.
  3. FNAC – if diagnosis is uncertain or infection/malignancy suspected.
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Nice question!
Thyroglossal duct cyst is the most likely diagnosis here. Dermoid cysts are also midline, but typically lower down (above suprasternal notch). Lipoma can also present and can be midline- but both these 2 will not move with deglutinition or tongue protrusion.

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Thyroglossal duct cyst-
The swelling is midline, just below the hyoid bone
It moves with deglutition (swallowing) which is characteristic.

Investigations-
Ultrasound neck
Thyroid scan

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Yes sir :+1::100:

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