Question
A patient presented with a painless swelling in the neck which moves up and down with swallowing and with protrusion of the tongue as shown in the picture below. About this condition,from the given options ,all are true except?
| A. |
Frequent cause of anterior midline neck masses in the first decade of life.
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| B. |
The cyst is located within 2 cm of the midline.
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| C. |
Incision and drainage is the treatment of choice.
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| D. |
Cyst can be moved sideways but not vertically
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Show Answer
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Correct Answer � C
Explanation
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Ans;C.)Incision and drainage is the treatment of choice.
The patient is suffering from Thyroglossal Cyst
THYROGLOSSAL CYST
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- It is congenital in origin.
- It is cystic swelling developed in the remnant of the thyroglossal duct or tract.
- CLINICAL FEATURES OF THYROGLOSSAL CYST
- Site – It may be present in any part of the thyroglossal tract (thyroglossal tract extends from foramen caecum to the isthmus of thyroid).
- Hyoid bone is closely associated with Thyroglossal cyst/fistula.
- Common sites are:
- Subhyoid (most common) in the region of the thyroid cartilages,
- Suprahyoid in the floor of mouth
- Beneath the foramen caecum
- It is a painless midline swelling, except in the region of the thyroid cartilage, where the thyroglossal tract is pushed to one side, usually to the left.
- It is located within 2 cm of the midline.
- Though its a congenital swelling most common age of presentation is between 2 to 4 yrs.
- Mobility – Cyst can be moved sideways but not vertically
- Peculiar characterstic which helps in distinguishing thyroglossal cyst from other neck swelling – it moves up with protrusion of tongue as the thyroglossal tract is attached to the tongue.
- It also moves with deglutition.
- COMPLICATIONS OF THYROGLOSSAL CYST
- Recurrent infection
- Formation of thyroglossal fistula.
- Thyroglossal cyst is congenital but thyroglossal fistula is never congenital. It follows infection or inadequate removal of a thyroglossal cyst.
- Carcinomatous change (usually Papillary carcinoma.)
- TREATMENT OF THROGOLSSAL CYST
- Excision of the thyroglossal cyst along with the track and the central part of body of the hyoid bone is the treatment of choice (Sistrunk’s operation).
- Incision and drainage can lead to fistula formation.
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