Question
30 year old patient with a 4 week H/O midline neck swelling which moves up on deglutition and protrusion of tongue as image given below. Diagnosis will be?
| A. |
Thyroglossal cyst
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| B. |
Plunging Ranula
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| C. |
Branchial cyst
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| D. |
Dermoid cyst
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Show Answer
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Correct Answer » A
Explanation
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The given clinical description suggests a midline neck swelling that moves upward with swallowing and when the tongue is protruded. This is characteristic of a thyroglossal cyst.
Thyroglossal cyst: This is the most common type of midline neck mass in children and can also be found in young adults. It originates from remnants of the thyroglossal duct, an embryonic developmental track that regresses and disappears but can occasionally persist and give rise to this cyst. The classic clinical sign of a thyroglossal cyst is its movement upward with deglutition (swallowing) and protrusion of the tongue, which distinguishes it from other neck masses.
Plunging Ranula: A ranula is a mucus-filled cyst that can arise in the floor of the mouth, typically lateral to the midline, due to obstruction or rupture of a salivary gland duct. A “plunging” ranula extends beyond the floor of the mouth into the neck but doesn’t exhibit the characteristic movement of a thyroglossal cyst with tongue protrusion or swallowing.
Branchial cyst: Branchial cleft cysts typically appear on the lateral aspect of the neck, not midline. They result from the failure of obliteration of the branchial cleft during embryonic development.
Dermoid cyst: Dermoid cysts in the neck are rare. They can be found anywhere on the body and are derived from entrapped skin elements during embryonic development. They don’t have the typical movement associated with thyroglossal cysts.
