Suprasternal Thyroglossal Cyst, case report

Abstract

The thyroglossal cyst is a congenital anomaly of the thyroid gland and the midline at the level 
of the neck; it affects 7% of the world's population. It presents as a painless tumor, mobile with 
swallowing. The diagnosis is made with ultrasound and fine needle aspiration biopsy, to determine 
the existence of malignancy, which corresponds to 1%. The treatment of choice is surgical using 
the Sistrunk technique. The case of a patient who goes to the otorhinolaryngology service of 
the Hospital de Clínicas is reported; male, 7 years old, with a history of chronic cervical tumor of 
intermittent growth at the level of the suprasternal cavity related to the appearance of infectious 
symptoms of the upper airways, which subsides with treatment based on antibiotics and non
steroidal anti-inflammatory drugs. A soft tissue ultrasound was performed on the patient, with 
a presumptive diagnosis corresponding to a thyroglossal cyst. A CT scan with contrast of the 
neck and chest was performed three months later, concluding a possible cervical cystic nodule 
categorized as a dermoid cyst. During the patient's follow-up, he presented a complication proven 
by cervical ultrasound that reported a small image of a heterogeneous collection in association 
with inflammatory changes in the affected region. A surgical intervention was planned and 
carried out for the resection of the lesion using the Sistrunk technique. The diagnosis was 
confirmed by anatomopathological study as a thyroglossal duct cyst located suprasternal, 
which turns out to be around 5% of the overall frequency of thyroglossal cysts. Furthermore, the 
application of Sistrunk surgery vs the modified maneuver was found to present similar rates of 
effectiveness. Since the thyroglossal cyst is the most common congenital cervical anomaly, it 
is important to recognize the appropriate management of this pathology with the addition to 
this case of its unusual location.