All Sample Questions

Thyroglossal Duct Cyst 1

Question

Vignette: A 45-year-old woman presents to the clinic with complaints of difficulty swallowing and a sensation of fullness in her neck. She has no relevant medical history. On examination, a mass is palpable in the midline of the neck, just above the sternal notch. The physician suspects a thyroglossal duct cyst. Which of the following is the most likely anatomical location of this cyst?

Choices

A) Anterior to the trachea

B) Posterior to the thyroid gland

C) Lateral to the sternocleidomastoid muscle

D) Medial to the parotid gland

E) Above the mylohyoid muscle

Answer

A) Anterior to the trachea

Explanation

Thyroglossal duct cysts are the most common congenital abnormalities in the neck. They are formed from a persistent thyroglossal duct, which is a temporary structure during embryological development that usually disappears by the 10th week of gestation. The duct begins at the foramen cecum at the base of the tongue, passes anterior to the hyoid bone, and descends anterior to the trachea to the location of the future thyroid gland. Therefore, thyroglossal duct cysts are typically found in the midline of the neck and can move with swallowing or protrusion of the tongue. They are most often located just below the hyoid bone but can occur anywhere along the path of the thyroglossal duct, which is always anterior to the trachea.