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What Is a Thyroglossal Duct Cyst?

Medically Reviewed by Dan Brennan, MD on May 20, 2021

A thyroglossal duct is a cyst or lump that develops in your neck or near your thyroid glands. It develops in the womb before birth and is usually diagnosed shortly after birth or during childhood.

Understanding a Thyroglossal Duct

A thyroglossal duct cyst occurs when the tissue in your neck doesn’t develop correctly. The malformation develops as a cyst or pocket of fluid on the front of the neck around the midline.‌

Usually, this malformation isn't painful, though it might be if the area becomes infected. If you have a thyroglossal duct cyst, you may be more likely to develop infections in your neck and throat.

A thyroglossal duct cyst may appear similar to other growths around the neck, including:

  • An epidermoid cyst, which is usually closer to the hyoid bone
  • A branchial cleft cyst, which usually forms on one side of the neck or the other, but not both‌
  • A bronchogenic cyst, which usually forms on the lower neck

This health problem can cause persistent infections that don’t go away or keep coming back. Your child’s thyroglossal duct cyst is more likely to become infected when they have another infection, like a cold, cough, or sore throat.

Symptoms of a Thyroglossal Duct Cyst

If your baby is born with a thyroglossal duct cyst abnormality, the obvious signs include having a small lump or opening on the front of their neck at birth. Other sinus-related symptoms may also appear.

The cyst may be infected if it's:

  • Red in color
  • Warm to the touch
  • Swollen
  • Painful ‌
  • Draining mucus or other liquid internally 

If your doctor notices any of these symptoms, your baby may need additional tests to receive an exact diagnosis. This is especially important since other neck conditions may need different treatment. In some cases, the lump isn’t large enough to be noticeable at birth. If there are no other symptoms, your child may not receive a diagnosis until between ages two and 10.

Diagnosing and Treating a Thyroglossal Duct Cyst

If you have concerns, talk to your child’s pediatrician. They ask about your child’s current symptoms and complete a physical exam. The doctor may feel your child’s neck for any inconsistencies in what is considered normal development.

Tests for diagnosing a thyroglossal duct include:

  • An ultrasound to identify any abnormalities under the skin
  • A CT scan may help determine how large the growth is. Your doctor injects dye into the area to make the growth more pronounced on imaging. ‌
  • Your doctor may take a biopsy of the growth to ensure it isn’t a cancerous or precancerous growth. This rules out other health conditions.

Treating a thyroglossal duct. If the condition isn’t severe, your doctor may want to leave it alone and monitor it over time. Keep in mind that the cyst will not heal or go away on its own without treatment.

If it causes health issues or impacts your child’s quality of life, your doctor takes into consideration your child’s:

  • Age‌
  • Symptoms
  • Severity and placement of the growth
  • Other health conditions

Antibiotics are prescribed to treat an infection, but if it persists, then surgery may be necessary. If your child gets recurring infections, surgery might be suggested to remove a malformation or close an opening caused by a thyroglossal duct. An endoscopic treatment may be available for less serious cases. This type of surgery doesn’t require an incision for repair and offers an easier recovery.

In more severe cases, a surgeon needs to cut an opening in the skin to remove a larger portion of tissue if the growth is cancerous. If the cyst is cancerous, additional treatment like radiation and chemotherapy may be needed.

Your child may stay overnight for monitoring following the surgery and go home the next day. A follow-up appointment may include additional imaging tests to ensure the mass was completely removed and the area healed correctly. Once a thyroglossal duct cyst is removed or repaired, it usually doesn’t return.

Risks of a Thyroglossal Duct Cyst

Thyroglossal duct malformations are usually small enough that they don’t have a significant impact on your health. However, if the mass is large enough, it may block your airways. This leads to difficulty breathing and swallowing.

Because the growths are near other vital structures, in rare cases, a thyroglossal duct can pose severe health risks to your:

WebMD Medical Reference

Sources

SOURCES:

Boston Children’s Hospital: “Thyroglossal Duct Cyst.”

Children’s Hospital of Philadelphia: “Thyroglossal Duct Cyst.”

Cooper Health: “Thyroglossal Duct Cyst.”

University of Iowa Health Care: “Thyroglossal Duct Cyst.”

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