Have you ever noticed a small, lumpy lump in the middle of your neck, or that of your child? Sometimes you can see it move up when you swallow. Don't worry! This could very well be a condition called a Thyroglossal Duct Cyst. Today, we're going to talk about this in detail, as if we were talking to a friend.
What is a Thyroglossal Duct Cyst?
Simply put, this is a small, soft lump that some people are born with, located in the middle of the neck. It can be felt and sometimes even visible. Most of the time, these lumps are about 2 centimeters in size. But this is not very common. It is said that about 7% of the population in countries like the United States has this condition.
Thyroglossal duct cysts can develop in both children and adults. However, they are most commonly seen in children under the age of 10. The best part is that 99% of these cysts are benign, meaning they are not cancerous . However, rarely, less than 1% of them can develop into cancer. Adults are more likely to develop such cancer than children. These cysts are treated with surgery. After being removed surgically, these cysts usually do not come back.
How serious can a Thyroglossal Duct Cyst be?
As I said before, most of the time these nuts don't cause any major health problems. However, in some cases, they can cause problems. Take a look:
- Very rarely, and I mean very rarely, these tumors can become cancerous .
- Some tumors can make it difficult to swallow food and drink . Doctors call this ``dysphagia.''
- These cysts can become infected . If they do, they can become painful.
Will this tumor get better on its own?
No, that doesn't happen. A thyroglossal duct cyst stays there until it is surgically removed.
What are the symptoms of a Thyroglossal Duct Cyst?
If you or your child has this type of tumor, you may first notice a lump in your neck, especially when you swallow . Or you may even see the lump when you stick out your tongue . Sometimes, it's discovered by chance when you go to see a doctor for another condition. There are a few other symptoms:
- These nuts are hard to get under your skin. If you touch them, they are soft, smooth, and round , and feel like small pieces of bread dough.
- If you or your child has an upper respiratory infection (like a cold or flu) , the infection can spread to the cyst, causing it to swell and become painful.
- Sometimes these cysts can burst , and a liquid-like substance can come out through the skin.
- Rarely, these cysts can cause difficulty swallowing food and drink .
What are the symptoms of Thyroglossal Duct Cyst cancer?
This is a very rare condition . Fewer than 300 cases of this type of cancer have been reported in the past 100 years. Even when it does occur, it affects adults more than children. Some people can have this cancer for years without any symptoms. Doctors often find it when treating other conditions, such as a goiter. Symptoms of a thyroglossal duct cyst include:
- It feels like there's a tumor on the front of my neck, and it seems to be getting bigger .
- I can feel a lump in the front of my neck, it feels hard .
- The lymph nodes are swollen .
- It is difficult to swallow food and drink .
Why does this thyroglossal duct cyst form?
These tumors form during gestation , when your body begins to develop the thyroid gland. The thyroid is a butterfly-shaped gland that produces hormones that control our metabolism. Simply put, this gland controls things like the rate at which we convert the food we eat into energy.
To form this thyroid gland, thyroid cells travel from the base of the tongue to the U-shaped bone called the hyoid bone, which supports our tongue. This journey takes place along a path called the thyroglossal tract. Normally, once the thyroid gland is in its proper place, this duct closes and dissolves. However, in some people, this duct does not close properly . That is when it fills with fluids and mucus, forming thyroglossal cysts. Researchers are still not sure why this duct does not dissolve in some people.
How do doctors diagnose a thyroglossal duct cyst?
Doctors diagnose this by examining your or your child's neck, then performing an ultrasound scan to determine the size of the tumor.
How do doctors find out if this is cancer?
Most often, doctors discover this type of cancer while treating another condition, for example, during surgery to remove a tumor. If they suspect that a tumor may be cancerous, they may do tests like these to confirm the suspicion:
- Fine needle biopsy: This involves using a thin, hollow needle and syringe to remove a sample of cells, fluid, or tissue from the tumor and examining it under a microscope or in a laboratory to see if the tumor contains cancer cells.
- CT scan (Computed tomography - CT scan): This uses a series of X-rays and a computer to create three-dimensional (3D) images of your neck.
- MRI Scan (Magnetic Resonance Imaging - MRI): This is a painless test that uses a large magnet, radio waves, and a computer to produce very clear images of the neck.
Does a Thyroglossal Duct Cyst Need to Be Removed?
Your doctor may recommend surgery, especially if the cyst is infected or if it is making it difficult for you or your child to swallow food or drink . Sometimes, even if the cyst is not causing any symptoms, your doctor may recommend surgery.
What kind of surgery is used to remove these tumors?
The most common surgery is called Sistrunk surgery . During this surgery, doctors make a small incision in your or your child's neck and remove the tumor, any remaining parts of the thyroglossal tract, and the middle part of your or your child's hyoid bone.
How long does it take to recover after Sistrunk surgery?
People who have had Sistrunk surgery can return to school or work in about a week . However, doctors may advise you to avoid strenuous activity, especially heavy lifting, for two to six weeks after surgery.
How is Thyroglossal Duct Cyst Cancer Treated?
If you have this type of cancer, your doctor will first recommend a Sistrunk procedure. They will then examine your lateral neck lymph nodes and thyroid gland. Depending on the results of those tests, they may recommend further surgery. For example:
- Total thyroidectomy: In this procedure, doctors remove all or part of your thyroid gland.
- Lateral neck dissection: All lymph nodes in the neck that may be affected by the tumor are removed.
- Radioactive iodine treatment (RAI): This treatment involves taking a pill containing radioactive iodine, which destroys any remaining cancer cells.
Can Thyroglossal Duct Cyst be prevented?
No. This tumor is congenital . That means a person is born with this tumor. Therefore, there is no way to prevent it.
What should I expect if my child has a Thyroglossal Duct Cyst?
In most cases, these tumors do not come back after they are removed with Sistrunk surgery. This means that the condition is almost completely cured. So, there is nothing to worry about.
What should I expect if I have Thyroglossal Duct Cyst cancer?
Research shows that about 95% of these cancers can be cured with surgery . Some people may also need to undergo radioactive iodine treatment after surgery. But the chances of recovery are much higher.
My child had a Thyroglossal Duct Cyst removed. When should I see the doctor?
If your child has any of these symptoms after surgery, you should see a doctor immediately:
- If there is a fever: This means the temperature is 38 degrees Celsius (100.4 degrees Fahrenheit) or higher.
- If there are signs of infection: such as redness, swelling, or pain.
- If there is fluid oozing from the surgical site.
- If the pain doesn't subside even after taking the painkillers prescribed by the doctor.
I had a cancerous tumor removed. When should I see the doctor?
Doctors may use different methods to treat a thyroglossal duct cyst. Therefore, ask your doctor about any specific complications that may occur after surgery. In general, see your doctor if you have any of the following:
- If you have a fever: If the temperature is 38 degrees Celsius (100.4 degrees Fahrenheit) or higher.
- If you see signs of infection: such as redness, swelling, or pain.
- If there is fluid oozing from the surgical site.
- You have pain, and even if you take the painkillers prescribed by the doctor, it doesn't go away.
What questions should I ask my doctor?
Thyroglossal Duct Cyst is a relatively rare condition, so you may be surprised to learn that your child has one. Or, if you have a cancerous tumor, you may have many questions to ask your doctor. Here are some questions to ask at such a time:
- What is a Thyroglossal Duct Cyst?
- Why did this happen to me/my child?
- Do I/my child need surgery?
- If I have surgery, can this tumor come back?
- My tumor is cancerous. What treatment do you recommend?
- What are the side effects of the treatment?
It's normal to feel a little worried if you see an unusual lump in your neck or that of your child. However, if it's a Thyroglossal Duct Cyst (TDC), you can rest easy, as these lumps are often benign and do not come back after being surgically removed .
Finally, things to remember
Imagine, if you find a small lump or tumor on your neck or your child's neck, it's normal to be a little worried, right? However, if it's a Thyroglossal Duct Cyst, it's comforting to remember that most of the time it's not dangerous. Most of these tumors are not cancerous . Like, they rarely come back after being removed with a 'Sistrunk surgery'.
However, very rarely, these can become cancerous. Even so, it is reported that with surgery and subsequent treatment if necessary, about 95% of cases can be cured.
Most of the time, a Thyroglossal Duct Cyst is painless. Also, some people don't even know they have it until they have difficulty swallowing. Therefore, if you notice a new lump or lump on your neck or on your child's neck, it's best to see a doctor without worrying too much about it. The doctor can then diagnose it and recommend treatment if necessary. Don't worry, there are solutions to everything!
Thyroglossal Duct Cyst, Thyroglossal Duct Cyst, Neck Cyst, Pediatrics, Sistrunk Surgery, Cancer, Congenital Diseases
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