thyroglossal duct cyst

• TDCs are benign and do not undergo malignant transformation. Rarely, patients may develop thyroid cancer from ectopic thyroid tissue trapped in the TDC but not from malignant degeneration of the cyst itself.
• Due to the risk of recurrent infections, a thyroglossal duct cyst (TDC) should be surgically removed. Resection should remove the entirety of the cyst as well as any fibrous tract remnants. The thyroglossal duct passes just posterior to the hyoid bone; therefore, the central portion of the hyoid is typically resected along with the tract to decrease the chance of recurrence.
• Levothyroxine has no impact on the size of a TDC. Should the patient develop hypothyroidism either before or after surgery, levothyroxine should be used to maintain a euthyroid state.
• Incision and drainage (I&D) is appropriate for an abscess, which can cause a neck mass but usually presents with significant pain and fever. I&D of a TDC should be avoided if possible because it increases the risk of recurrence after definitive resection (likely due to disruption of tissue planes making the tract more difficult to identify and remove).