Thyroglossal duct cysts.

The thyroglossal duct cyst (TGDC) is the most common congenital neck mass and the second most common of all childhood cervical masses. An anterior midline neck mass presenting before the age of twenty and displaying vertical movement with tongue protrusion and swallowing is characteristic of this lesion. Though concomitant agenesis of the thyroid is extremely rare, documentation of a normal thyroid preoperatively has become a legally protective requirement. Carcinoma in a TGDC is unusual and is rarely detected preoperatively, but a fine needle aspiration is helpful if a malignancy is suspected. Regardless, the treatment is a Sistrunk procedure: excision of the cyst, the tract connecting it to the foramen cecum, and the central portion of the hyoid bone.