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Stephen Simoneaux, MD
Adina Alazraki, MD
Kimberly Applegate, MD
Denis Atkinson, MD
George Atkinson, MD
Shelli Bank, MD
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Paula Dickson, MD
Chad Holder, MD
Jonathan Loewen, MD
Robert Lorenzo, MD
Ellen Patrick, MD
Shelly Shiran, MD

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Answer...
A 14 month old presents with a lump at the base of the floor of the mouth which is visible near the midline

Ultrasound- long view

Ultrasound transverse

Sagittal CT through area of mass

Coronal CT through area of mass

 Place cursor over image for additional view

coronal CT video
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What is the likely source of the mass?

Thyroglossal Duct Cyst

What is the important finding on the coronal CT?

Well-circumscribed cystic mass at the base of the tongue WITH normal thyroid gland

Discussion:  A thyroglossal duct cyst may be discovered incidentally on exam, but importantly, it may be the only source of thyroid tissue.  This needs to be evaluated at the time of discovery.  The cyst tends to be slightly off-midline and can occur anywhere from the base of the tongue to the thyroid bed.  When removed, it is important to remove the body of the hyoid bone, since the duct usually passes through this structure and the cyst will regrow unless the body is removed.

NEW CASE COMING SOON!!!

( this is an important case for on-call residents reading pediatric CT exams after hours!)

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