An unusual presentation of a thyroglossal duct cyst with cutaneous extrusion

Abstract

Background: Thyroglossal duct cysts (TGDC) are the most common form of congenital cysts in the head and neck and usually presents as a midline neck mass at the level of the thyrohyoid membrane. We report a case of an atypical presentation of a thyroglossal duct cyst with cutaneous extrusion. To our knowledge, this is the first case to be reported in the English literature. Methods: A 92-year-old female presented with a 5-year history of an ulcerated midline neck mass with anterior cutaneous extrusion. A computer tomography (CT) scan of the neck showed a cystic mass posteroinferior to the hyoid bone highly suggestive of a thyroglossal duct cyst. Written informed consent from the patient's family was obtained for this case report. Results: The patient underwent a modified Sistrunk procedure and final histopathology confirmed it to be a thyroglossal duct cyst measuring 10cm in its largest dimension. The patient tolerated the procedure well. Conclusion: Cutaneous extrusion of a thyroglossal duct cyst is extremely rare. Although skin ulceration usually suggests underlying malignancy, benign entities may also result in such aggressive presentations. A differential diagnosis of a carcinoma should be considered in an ulcerative midline mass with close relations to the hyoid bone.