Question

A 23-year-old male patient presents with midline swelling in the neck. The swelling moves withdeglutition and protrusion of the tongue. What is the likely diagnosis?

• A. Brachial cyst
• B. Thyroglossal cyst
• C. Plunging ranula
• D. Dermoid cyst

Answer 1

The Correct Option is B

The clinical presentation described is indicative of a thyroglossal cyst. Let's analyze the key elements of the scenario:

1. The patient has a midline neck swelling. Thyroglossal cysts are commonly found in the midline or slightly off to either side of the neck, typically near the hyoid bone.
2. The swelling moves with deglutition (swallowing) and protrusion of the tongue. This movement is characteristic of a thyroglossal cyst because it is attached to the thyroglossal duct, which runs from the base of the tongue to the thyroid gland. As a result, movement of the tongue or swallowing causes the cyst to move.

Based on these observations, the clinical signs align with a thyroglossal cyst rather than other options provided:

• A brachial cyst typically presents as a lateral neck swelling and does not move with swallowing or tongue protrusion.
• A plunging ranula is usually found in the floor of the mouth and submandibular area and doesn't exhibit movement with swallowing or tongue movement.
• A dermoid cyst can appear in the neck but does not typically move with deglutition or tongue protrusion.

Therefore, based on the location and characteristic movements associated with the swelling, the likely diagnosis is a thyroglossal cyst.