Asymptomatic Thyroglossal Duct Cyst In A 20 Years Old Male

Patient Information:
A 20-year-old male presented with a two-week history of anterior neck swelling. He is a non-smoker and denies any associated symptoms such as pain, dysphagia, voice changes, or respiratory distress. His general condition is stable, and there are no signs of systemic infection or thyroid dysfunction.

Laboratory Investigations:
The patient’s laboratory workup showed normal inflammatory and thyroid function markers. His C-Reactive Protein (CRP) was 0.11 mg/L, indicating no significant inflammatory process. Thyroid function tests were within normal limits, with a free thyroxine (FT4) level of 1.37 ng/dL and a thyroid-stimulating hormone (TSH) level of 1.91 µIU/mL, suggesting a euthyroid state.

Neck Ultrasound Findings:
Ultrasound of the neck revealed a loculated cystic lesion measuring 28 × 14 × 16 mm located in the upper anterior midline and extending slightly to the left. The lesion contained a few thin septations, with features suggestive of a thyroglossal duct cyst. The thyroid gland was normal in size and echotexture, with no nodules or signs of thyroiditis. The parotid and submandibular glands appeared normal, and there was no evidence of pathological deep cervical lymphadenopathy. However, bilateral benign-appearing cervical lymph nodes (<11 mm in size) were noted, likely reactive in nature.

Management Plan:
As the patient is asymptomatic and has no signs of infection or compression, a conservative approach was adopted. He is scheduled for clinical follow-up without immediate surgical intervention. If symptoms develop or the lesion enlarges, further evaluation and possible surgical excision may be considered.

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