International Journal of Clinical & Medical Images

A 47-year-old man without medical history was referred for an asymptomatic left large cervical mass, appeared 6 years ago and gradually evolving. It was measured on the pre-operative CT-scan at 8.5 cm in the anterior-posterior diameter, 8 cm in height and 7.5 cm in the transverse diameter. The thyroid was present, without biological dysthyroidism and the parathormone were normal. A fine-needle aspiration cytology was negative. The lesion was removed by a left cervicotomy after a negative upper aerodigestive tract endoscopy. The pathological analysis diagnosed a thyroglossal cyst without any sign of malignancy. No recurrence was observed after 2 years of follow-up.

A cystic cervical mass in patients over age 40 must be considered first as a cervical lymphadenopathy related to an HPV positive oropharyngeal squamous cell carcinoma. Others diagnosis should be discussed, like a lymphoma, a second cleft cyst, a laryngocoele, a papillary thyroid carcinoma, a macrocystic lymphatic malformation, a parathyroid cyst, or a cystic cervical schwannoma.