How is a thyroglossal duct cyst diagnosed in children?

After examining your child’s neck and throat, the doctor will usually perform an imaging test to get a detailed view of the cyst. Based on these images, the doctor can diagnose the thyroglossal duct cyst.

Common types of imaging tests we use to diagnose thyroglossal cysts:

  • Ultrasound exam: This test uses soundwaves to make pictures of the cyst.
  • CT Scan (Computed Tomography Scan): This test is a type of x-ray that uses contrast dye to help make clear pictures. Contract dye can be swallowed or injected into a vein through an intravenous catheter (IV).
  • Magnetic Resonance Imaging (MRI): For this test, a big camera uses magnetic fields and radio waves to make pictures of the cyst.

A thyroglossal duct cyst usually does not go away on its own. In some cases, surgery is needed to drain and remove the cyst. If your child needs surgery, an imaging test will also tell the doctor how much healthy thyroid tissue your child to help them heal.

Your child’s doctor may also choose to perform a blood test to check how well the thyroid gland can create hormones in the blood. They may also do a fine needle aspiration. This is when a doctor uses a thin needle to remove cells from the cyst and checks the cells under a microscope. The doctor will use numbing medication on your child’s skin before doing a fine needle aspiration.

How is a thyroglossal duct cyst treated in a child?

Thyroglossal duct cysts will not go away without treatment. However, your child may not need to get rid of the cyst if they do not experience complications, such as repeated infection or major swelling. Some people choose to remove the cyst because they do not like how it looks. They may also be worried about future complications.

The Pediatric Surgery team at MGHfC will work with you and your child to decide which type of treatment your child needs, based on how often and how severely their thyroglossal duct cyst gets infected. Any infection in the cyst will be treated before surgery to make surgery safer for your child.

Thyroglossal duct cyst treatments include:

  • Antibiotic medicine to treat infection
  • Draining the cyst to treat infection
  • Excision (surgically removing the cyst)
  • Sistrunk procedure (surgically remove the cyst and all root tissue)

The Sistrunk procedure is a type of surgery that removes the root of the cyst in the hyoid bone in the throat. The hyoid bone supports the tongue. Surgically removing all the extra cells and tissue left in the thyroglossal duct makes it less likely that the cyst will come back. Only about 10 out of every 100 thyroglossal duct cysts come back after the Sistrunk procedure.

Our Pediatric Surgery team will provide the best care possible and guide you and your child through a safe recovery. Complications (medical concerns that happen after a medical procedure or treatment) after surgery can include clotting, infection, or a fistula (an infected tunnel that may leak fluids from the location of the surgery). After surgery, your child will have a small scar on their neck. If this worries you or your child, please talk with the care team.

Can thyroglossal duct cysts cause cancer in children?

It is rare for thyroglossal duct cysts to cause cancer in children. Only 1 out every 100 thyroglossal duct cysts become cancerous. Malignant (cancerous) thyroglossal cysts are more commonly found in adults. To treat cancerous thyroglossal duct cysts, doctors perform the Sistrunk procedure and an evaluation of the thyroid and lymph nodes (small, bean-shaped structures that fight infection and disease) in the neck.