The differential diagnosis of a pediatric neck mass includes congenital, infectious, and neoplastic etiologies, but a thyroglossal duct cyst (TGDC) should move high on the list for a painless, midline anterior neck mass that elevates with swallowing or tongue protrusion. TGDCs are the most common congenital neck masses and result from the failure of the thyroglossal duct to involute during descent of the embryologic thyroid gland. As seen in this case, the Sistrunk procedure (resection of the cyst, thyroglossal tract, and central portion of the hyoid bone) is preferred over simple excision due to its lower risk of recurrence.
Comment
The differential diagnosis of a pediatric neck mass includes congenital, infectious, and neoplastic etiologies, but a thyroglossal duct cyst (TGDC) should move high on the list for a painless, midline anterior neck mass that elevates with swallowing or tongue protrusion. TGDCs are the most common congenital neck masses and result from the failure of the thyroglossal duct to involute during descent of the embryologic thyroid gland. As seen in this case, the Sistrunk procedure (resection of the cyst, thyroglossal tract, and central portion of the hyoid bone) is preferred over simple excision due to its lower risk of recurrence.