Giant thyroglossal cyst in an elderly patient

Area of Science:

• Medicine
• Surgery
• Pathology

Background:

• Thyroglossal duct cysts (TGDs) are congenital anomalies typically diagnosed in childhood.
• Late-onset TGDs are uncommon, presenting diagnostic challenges due to atypical features.

Observation:

• A 65-year-old male presented with a progressively enlarging right neck swelling over one year.
• The swelling moved with deglutition but not with tongue protrusion, suggesting a midline neck mass.
• Initial investigations including Fine Needle Aspiration Cytology (FNAC) and ultrasonography indicated a possible TGD.

Findings:

• Surgical excision via the Sistrunk operation was performed.
• Histopathological examination confirmed the diagnosis of a thyroglossal duct cyst.
• The cyst was notably large, multilobular, and presented in an elderly patient, deviating from typical TGD characteristics.

Implications:

• This case underscores that thyroglossal duct cysts can occur and present atypically in older individuals.
• The findings emphasize the importance of considering TGD in the differential diagnosis of neck masses, regardless of patient age or classic signs.
• Successful management with the Sistrunk operation confirms its efficacy even in complex, late-onset cases.