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A Rare Case of a Thyroglossal Duct Cyst in Sublingual and Sub-mental Region Present as Submental Abscess

Dr.Dnyaneshwar Bharat Ahire

Thyroglossal duct cyst is the most common congenital anomaly which arises from the remnants of the thyroglossal duct and occurs in 7% of the adult population [1]. It is a fibrous cyst that forms from a persistent thyroglossal duct. The most common locations for a thyroglossal cyst are midline or slightly off midline, between the isthmus of the thyroid and the hyoid bone or just above the hyoid bone. A thyroglossal cyst can develop anywhere along a thyroglossal duct. The presentation of thyroglossal duct cyst on the tongue is quite uncommon [2] and is named Lingual Thyroglossal Duct Cyst (LTDC). Thyroglossal duct cysts most often presents with a palpable asymptomatic midline neck mass below the level of the hyoid bone. Up to half of thyroglossal cysts are not diagnosed until adult life. If left untreated, LTDC may present with life-threatening airway obstruction. We report a case of 25 years old male with LTDC due to its rare occurrence. Case Report A 25 yr old young male presented with swelling in submental region (Figure 1) since 8 months. This swelling was subjected to reduce in size on pressing leading to purulent discharge from foramen caecum. There was no history of dysphagia or odynophagia. Clinical examination On examination there was 5 x 3 cm size swelling seen in submental region with no localised sign of inflammation. The swelling moved on protrusion of tongue and deglutination. The swelling was soft in consistency and lead to purulent discharge from foramen caecum on pressing. There were no signs of cervical lymphadenopathy. It has been reported that over 7% of adults have some remains of the thyroglossal duct and over 62% of them may have some ectopic thyroid tissue. Most neoplasias in the thyroglossal duct are made up of papillary carcinomas [5]. Antibiotics are indicated if infection is suspected. Definitive surgical management requires excision not only of the cyst but also of the path’s tract and branches. Conclusion This is a rare presentation of thyroglossal cyst in an adult patient presented with swelling in submental region.