[Thyroglossal duct cyst in hyoid bone]

Area of Science:

• Otolaryngology
• Surgical Pathology

Background:

• Thyroglossal duct cysts (TDCs) are congenital anomalies typically found in the midline of the neck.
• While commonly located in the suprahyoid or infrahyoid regions, intralingual or suprasternal presentations are less frequent.
• Intraosseous TDCs within the hyoid bone itself represent an exceptionally rare anatomical variant.

Observation:

• A 62-year-old patient presented with a significant, painless, solid swelling in the medial neck.
• The swelling was identified as a large thyroglossal duct cyst situated within the substance of the hyoid bone.
• Associated symptoms included dysphagia (difficulty swallowing) and dyspnea (breathing difficulties), which are atypical for TDC.

Findings:

• Histopathological examination confirmed the diagnosis of a thyroglossal duct cyst.
• Surgical excision involved the en bloc removal of the involved segment of the hyoid bone along with the cyst.
• Post-operative follow-up for one year revealed complete resolution of the patient's symptoms and no evidence of cyst recurrence.

Implications:

• This case highlights the importance of considering rare anatomical locations for thyroglossal duct cysts.
• Surgical management involving resection of the involved hyoid bone may be necessary for intraosseous TDCs.
• Complete excision is crucial for preventing recurrence of thyroglossal duct cysts, even in unusual locations.