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Can A Thyroglossal Duct Cyst Develop After A Thyroidectomy?
Question: Hello, is it possible to develop a thyroglossal duct cyst several years after a subtotal thyroidectomy? I have a dime sized lump in my front midline neck area that can be seen in the mirror. If I touch it too often it hurts and feels like my throat is really tight. I had a CT scan one year ago that showed NO cysts, masses or lesions in my neck. One ENT doctor says it's a superficial lymph node, another ENT doctor says neck tension in hyoid bone area. Should I keep digging for answers?
Brief Answer:
A FNA needed:
Detailed Answer:
Hello and thank you for asking!
I have gone carefully through your concern.
An infected thyroglossal cyst can be enlarged at your age but during the exams you have done for the thyroid gland (ultrasound and scintiscan) it should have been diagnosed before.
If it was invisible before and you think that now is enlarged due to infection, the radiologic exams should have revealed it before.
Anyway, a fine needle aspiration would give exact information regarding to it's nature.
Hope the information will help.
Kind regards,
Dr.Mirjeta
A FNA needed:
Detailed Answer:
Hello and thank you for asking!
I have gone carefully through your concern.
An infected thyroglossal cyst can be enlarged at your age but during the exams you have done for the thyroid gland (ultrasound and scintiscan) it should have been diagnosed before.
If it was invisible before and you think that now is enlarged due to infection, the radiologic exams should have revealed it before.
Anyway, a fine needle aspiration would give exact information regarding to it's nature.
Hope the information will help.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Remy Koshy
Hello doctor,
I haven't had a neck ultrasound since before my Thyroid surgery in 2009, however yes I had a neck CT with contrast a year ago when I felt/saw this lump. The lump and the throat tightness is why my ENT doctor sent me for the test. The Radiologist's report did not acknowledge any lumps or masses, however my ENT doc and I could see "something" on the screen when he went over the test results with me. The ENT doctor explained that because they were so small (less than 1cm) that the radiologist probably didn't consider them significant. The ENT doctors opinion was that they were "superficial lymph nodes". I saw a second ENT doctor who reviewed the test results and agreed, with another possible explanation of neck tension in the area of the hyoid bone.
The lump is no bigger or smaller a year later however it does seem to swell if I touch it too often and it's causing me some anxiety. I have also seen my endocrinologist in recent months and she physically examined my neck and was not concerned about anything abnormal.
Do you think the CT scan test was sufficient enough, or should I insist on an ultrasound and FNA?
I haven't had a neck ultrasound since before my Thyroid surgery in 2009, however yes I had a neck CT with contrast a year ago when I felt/saw this lump. The lump and the throat tightness is why my ENT doctor sent me for the test. The Radiologist's report did not acknowledge any lumps or masses, however my ENT doc and I could see "something" on the screen when he went over the test results with me. The ENT doctor explained that because they were so small (less than 1cm) that the radiologist probably didn't consider them significant. The ENT doctors opinion was that they were "superficial lymph nodes". I saw a second ENT doctor who reviewed the test results and agreed, with another possible explanation of neck tension in the area of the hyoid bone.
The lump is no bigger or smaller a year later however it does seem to swell if I touch it too often and it's causing me some anxiety. I have also seen my endocrinologist in recent months and she physically examined my neck and was not concerned about anything abnormal.
Do you think the CT scan test was sufficient enough, or should I insist on an ultrasound and FNA?
Brief Answer:
About the lymph node:
Detailed Answer:
Welcome back!
From your description it is very suggestive for an infected thryeoglossal cyst.
Anyway, if the ENT has excluded it, than a superficial lymph node is the remained diagnosis.
If it is something that bothers you, comes and goes and is painful with local signs of infection (red skin, edema ect) your treating physician may recommend antibiotics for 1 week.
If no signs of infections are present and the dimensions are the same during the last 6 months or year, than there is no need to get worried.
If you are really concerned about it, you may insist for the FNA.
Best wishes,
Dr.Mirjeta
About the lymph node:
Detailed Answer:
Welcome back!
From your description it is very suggestive for an infected thryeoglossal cyst.
Anyway, if the ENT has excluded it, than a superficial lymph node is the remained diagnosis.
If it is something that bothers you, comes and goes and is painful with local signs of infection (red skin, edema ect) your treating physician may recommend antibiotics for 1 week.
If no signs of infections are present and the dimensions are the same during the last 6 months or year, than there is no need to get worried.
If you are really concerned about it, you may insist for the FNA.
Best wishes,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Prasad
Hello doctor,
I've had antibiotics within the past year for other infections (sinus and uti) with no change in the lump. There is no redness or skin edema. I'm curious though, isn't a thyroglossal duct cyst present from birth and considered a congenital anomaly? I thought this was something that was usually found in children. It wasn't noted when I had Thyroid surgery in 2009. Possible for me to just now develop a thyroglossal duct cyst at my age? If so, is watching and waiting an acceptable approach or should I be more concerned? I see my endocrinologist next month and I will also discuss with her.
I've had antibiotics within the past year for other infections (sinus and uti) with no change in the lump. There is no redness or skin edema. I'm curious though, isn't a thyroglossal duct cyst present from birth and considered a congenital anomaly? I thought this was something that was usually found in children. It wasn't noted when I had Thyroid surgery in 2009. Possible for me to just now develop a thyroglossal duct cyst at my age? If so, is watching and waiting an acceptable approach or should I be more concerned? I see my endocrinologist next month and I will also discuss with her.
Brief Answer:
About thyroglossal cyst;
Detailed Answer:
Hi again,
Up to half of thyroglossal cysts are not diagnosed until adult life.
The tract can lie silent for years or even decades, until some kind of stimulus leads to cystic dilation. Infection can sometimes cause the transient appearance of a mass or enlargement of the cyst, at times with periodic recurrences.
Of course it should have been diagnosed before, as you have done exams even surgery of the thyroid gland.
Anyway, even if it is diagnosed at this age, surgical removal is suggested if recurrent infections occur.
Best wishes,
Dr.Mirjeta
About thyroglossal cyst;
Detailed Answer:
Hi again,
Up to half of thyroglossal cysts are not diagnosed until adult life.
The tract can lie silent for years or even decades, until some kind of stimulus leads to cystic dilation. Infection can sometimes cause the transient appearance of a mass or enlargement of the cyst, at times with periodic recurrences.
Of course it should have been diagnosed before, as you have done exams even surgery of the thyroid gland.
Anyway, even if it is diagnosed at this age, surgical removal is suggested if recurrent infections occur.
Best wishes,
Dr.Mirjeta
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Above answer was peer-reviewed by :
Dr. Prasad
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