Mass lesions of the head and neck in infants and children can be either developmental, inflammatory or neoplastic. Lymphomas (Hodgkin’s or Non-Hodgkin’s) commonly present as neck lumps in children. Although malignancy is not the commonest aetiology of paediatric cervical lumps, a high index of suspicion is critical to facilitate early diagnosis and treatment of cervical lesions. We present the case of a 15-year-old boy who presented with a solitary midline cervical lesion, which simulated a thyroglossal cyst on clinical examination. However, histopathological examination revealed it to be a Hodgkin’s lymphoma. Related literature is also reviewed.

The case is described of a boy who presented at age six months with symptoms and signs of a thyroglossal cyst, which seemed to be confirmed by ultrasound findings. The cyst slowly increased in size, and eventually the patient underwent Sistrunk’s procedure at age four years. Histology showed that the cyst was in fact a mixed thyroglossal and dermoid cyst. This casts doubt on the doctrine that thyroglossal cysts and dermoid cysts are anatomically and histologically separate entities, and strengthens the view that these cysts should be more appropriately named ’thyroglossal abnormalities’.

Thyroglossal duct cysts most frequently present in childhood as painless midline swellings around the level of the hyoid. Classically the cyst moves upwards on protruding the tongue. Here we report a novel case of a thyroglossal cyst in an adult in whom the history, examination and fine needle aspiration cytology were typical of a traumatic haematoma. This case is also unique because the thyroglossal duct cyst extended beyond the thyroid gland to the suprasternal notch and actually required two parallel transverse cervical incisions for its complete en bloc removal.

Sistrunk’s procedure for thyroglossal duct remnants has a very high success rate, there remains the occasional patient, however, that will have recurrent disease despite a competently performed operation. Applied anatomy and embryology proffer a solution to this problem. Extending the Sistrunk operation, with an anterior wide local excision remaining within normal tissue, enables removal of the entire thyroglossal tract remnant.

A retrospective case note review was conducted to study our experience using this extended procedure to treat patients with thyroglossal tract disease that had recurred after a previous Sistrunk’s operation.

Six patients aged from five to 33 years were included in the study. There was one recurrence and the complication rate was comparable to the standard operation.

It was concluded that a wide local excision is a valuable extension of the Sistrunk operation for the management of recurrent disease.

Both thyroglossal cysts and aberrant thyroid tissue may present as a mid-line neck swelling. We report a case of autoimmune thyroiditis presenting as a thyroglossal swelling in a middle-aged woman. This very rare finding is discussed with reference to the optimal management of thyroglossal tract swellings.

Thyroglossal duct remnants presenting as a lump in the neck are usually called thyroglossal cysts. Meticulous dissection of the cyst and duct, along with the body of the hyoid bone (Sistrunk’s operation) is necessary to avoid recurrence. The authors have reviewed the histology of 61 consecutive specimens diagnosed preoperatively as thyroglossal cysts and have found that a true cyst exists in only 46 per cent of cases.

Papillary carcinoma arising in a thyroglossal duct cyst is a rare finding. Less than 100 cases have been reported in the English literature. In most cases the diagnosis is only established after excision of a clinically benign thyroglossal duct cyst. The aetiology of such tumours is unclear but de novo origin and spread from a primary thyroid gland tumour has been suggested. This has important implications for therapeutic approaches. A further case of thyroglossal duct carcinoma is presented and the management is discussed on the basis of the current rationale for treatment of thyroid cancer.

Although a thyroglossal duct cyst (TDC) is a common cyst occurring in the neck, carcinomas arising in the TDC are a rare event. To date, approximately 100 cases have been reported, the majority of them being papillary carcinomas. Squamous cell carcinomas (SCC) are very rare, and Only nine cases have been reported so far in the literature.

We present a 55-year-old female patient with a SCC in a TDC to highlight the clinical and pathological features of this condition.

The authors report a case of an unusual inflammatory reaction in a thyroglossal cyst. It consisted of broad papillary intraluminal projections covered by histiocytes and occasional multinucleate giant cells. This benign process should not be confused with a true papillary neoplasm, a rare complication of a thyroglossal cyst.

A case is presented of a laterally occurring thyroglossal cyst. In conventional teaching, thyroglossal duct remnants occupy the midline, or a position adjacent to the midline, and are found in a line marking the descent of the thyroid anlage and move upwards on protruding the tongue. Laterally presenting thyroglossal duct remnants are unusual.

Lingual thyroid is a rare lesion caused by maldescent of the thyroid gland. It is an important cause of a mass on the posterior third of the tongue, and may coexist with other developmental abnormalities such as thyroglossal cyst. The diagnosis is made by radioisotope scan. Treatment is indicated in the presence of symptoms and consists initially of thyroxine. Severe or unresponsive cases require complete excision through a lateral pharyngotomy. Hypothyroidism is common postoperatively, but may be avoided in some cases by transplantation of excised tissue. We present a case report and review of the literature

We report a case of a partly ossified thyroglossal cyst in close proximity to the hyoid bone and discuss the possible embryological significance of this. Thyroglossal cysts occurring within the hyoid bone or deep to the hyoid periosteum support previous suggestions that the thyroglossal tract can sometimes be trapped within the developing hyoid bone.