Pediatric Thyroglossal Duct Cyst

A thyroglossal duct cyst is a pocket in the front part of neck that is filled with fluid. A child may be born with this cyst. It is formed from leftover tissue from the development of the thyroid gland when an embryo was forming. The thyroid gland is located in the front of the neck. It is part of the hormone-producing glands called the endocrine system.

Although the cyst is present at birth, it is often not found until a child is at least age 2. Often a healthcare provider finds a thyroglossal cyst when a child gets an upper respiratory infection.

The thyroid gland forms during the early stages in the development of an embryo. It begins at the base of the tongue and moves down the neck through a channel or tube (thyroglossal duct). This duct normally goes away once the thyroid reaches its final position in the neck. Sometimes part of the duct remains. This leaves a pocket called a cyst.

Symptoms can occur a bit differently in each child. The most common include:

• A small, soft, round lump in the center front of the neck
• Tenderness, redness and swelling of the lump, if infected
• Trouble swallowing or breathing

The symptoms of a thyroglossal duct cyst can seem like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

A thyroglossal cyst is often diagnosed when your child’s healthcare provider examines your child. The provider will often advise that your child see an ear, nose and throat doctor (ENT or otolaryngologist). Or the provider may refer you to another healthcare provider with experience in thyroglossal duct cysts. Your child may need tests such as:

• Blood tests. These tests check the thyroid gland function.
• Ultrasound exam. Sound waves are used to check the cyst and thyroid gland.
• CT scan of the neck. X-rays and a computer are used to look at the neck, including the cyst and thyroid gland. Contrast dye is used to get better images. 
• Fine needle aspiration. A small needle is used to remove cells from the cyst for diagnosis. 

Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.

Your child’s healthcare provider will regularly check your child’s cyst. Treatment may include:

• Antibiotic medicine
• Cutting into and draining the cyst, if antibiotic medicine doesn’t get rid of the infection
• Cutting out the cyst and some nearby tissue (surgical excision). This is the most common treatment.
• Injecting a substance to remove the cyst, if a child can’t have surgery

Complications of a thyroglossal duct cyst may include:

• Blocking the upper airway
• Serious or returning infection
• Presence of cancer cells, but this is uncommon