Dental hygiene screening reveals childhood neck mass

A benign neck mass was discovered in a young child which, based on presentation, was diagnosed as a thyroglossal duct cyst. Thyroglossal duct cysts normally appear in childhood and are usually asymptomatic. They are a congenital neoplasm resulting from incomplete resorption of the thyroglossal duct following the embryonic descent of the thyroid gland and are often found attached to the hyoid bone. They may or may not have exterior fistulae and are slow growing. Other types of neck masses should be included in a complete differential diagnosis, as this case verified. Masses such as the dermoid cyst may be misdiagnosed as TGDC. While also slow growing, and presenting similarly to the TGDC, dermoid cysts may enlarge and compromise airways and interfere with eating and swallowing. Treatment of choice for these neck masses is excision including ductal remnants. Care must be taken not to remove ectopic thyroid tissue if that is the entire extent of the patient's thyroid gland. This case presentation exemplifies the role of the dental hygienist in identifying lesions of the head and neck and seeking appropriate referral when indicated. The dental hygienist if ideally suited to perform complete extraoral and intraoral examinations by virtue of education and training. Routine examinations must extend beyond the intraoral structures to include the head and neck regions. One must not assume that pathology exists only in the older population.