Thyroglossal duct remnant cyst in a pediatric patient: case report

Abstract

Introduction: Thyroglossal duct cysts are the most common congenital cervical anomaly and the most common pediatric mass. They form in the neck due to the persistence of parts of the primitive thyroglossal duct or due to its failure to close. Most are solitary and located below the hyoid bone, with a few cases occurring at the base of the tongue. Case description: A 12-year-old male with a 1-week history of acute pharyngotonsillitis managed with 500 mg of amoxicillin every 12 hours for 5 days. At the end of treatment, his mother watched an increase in the submandibular region, for which he was evaluated. On physical examination, a painful, warm, non-erythematous submandibular mass was palpated, with well-defined borders, measuring 6 x 10 centimeters, with the presence of exudate and grade IV tonsillar hypertrophy. He did not have difficulty swallowing or breathing. Laboratory studies: Hemoglobin 14.9 mg/dL, Hematocrit 43.5 mg/ dL, Platelets 381,000 U/L, Leukocytes 24,900 U/L, Neutrophils 18,400 U/L, Procalcitonin 0,046, C-Reactive Protein 40.70 mg/L. Neck ultrasound on admission: Cystic lesion in level VI superior to the left thyroid lobe, probable abscessed adenopathy, content 6.5 milliliters. Management: ceftriaxone, clindamycin and dexamethasone, without remission of the condition. Follow-up at 4 weeks Doppler ultrasound reports remnant cyst of the thyroglossal duct. Conclusion: The diagnosis of thyroglossal duct remnant cyst in children should be established quickly by imaging studies to rule out systemic disease or malignancy and to prevent complications.