• Epidemiology
  1. Incidence: 7%
  2. Most commonly presents in childhood
  • Pathophysiology
  1. Residual vestigial tract from fetal development
    1. Tract left by descending Thyroid during Embryogenesis
    2. Tract courses from Tongue base to anterior neck
  • Signs
  1. Cystic mass at midline of neck adjacent to Hyoid Bone
    1. Increases in size after Upper Respiratory Infection
  2. Mass moves upward (vertically) on:
    1. Swallowing
    2. Protruding Tongue
  • Complications
  1. Cyst infection (follows Upper Respiratory Infection)
  2. Papillary carcinoma (in adults)
  • Differential Diagnosis
  1. See Neck Masses in Children
  2. See Neck Masses in Adults
  3. Undescended Lingual Thyroid (as high as 1-2%)
  • Radiology
  • Confirms normal Thyroid separate from cyst
  1. Radionuclide Thyroid Scan or
  2. Neck Ultrasound
  • Management
  1. Surgical excision of cyst, tract (Sistrunk Procedure)
  • References
  1. Townsend (2001) Sabiston Surgery, Saunders, p. 546
  2. Ewing (1999) Eur Arch Otorhinolaryngol 256(3):136-8 [PubMed]
  3. Gupta (2001) Arch Otolaryngol Head Neck Surg 127:200-2 [PubMed]