# Ingrowing thyroglossal duct cyst presenting as a throat mass: A clinical pearl illustrated in two adult patients

## TL;DR

Two adult patients with throat masses were diagnosed with thyroglossal duct cysts after initial suspicion of cancer, highlighting the importance of considering this rare condition in adults.

## Contribution

This paper presents two rare cases of thyroglossal duct cysts in adults that presented as throat masses, emphasizing the need for thorough imaging review.

## Key findings

- Two adult patients presented with symptoms mimicking throat cancer but were diagnosed with thyroglossal duct cysts.
- Computed tomography imaging was crucial in identifying intralaryngeal and intralingual thyroglossal duct cysts.
- The Sistrunk procedure provided definitive diagnosis and symptom resolution in both patients.

## Abstract

Thyroglossal duct cyst (TGDC) is the most common congenital neck cyst and typically presents as an upper midline neck mass. Rarely, the cyst may present as a pharyngolaryngeal mass by forming posterior to the hyoid without an external palpable component and can present in adults with symptoms that mimic that of oropharyngeal or laryngeal malignancies.

We evaluated two adult male patients for a chief complaint of dysphagia and globus sensation. Both patients had exophytic submucosal masses arising from the vallecula or hypopharynx, raising concern for neoplasm. Incisional biopsy was frustrated by the submucosal location and found to be negative on pathologic examination. However, a diagnosis of intralaryngeal and intralingual TGDC was made radiographically after reviewing the post-biopsy imaging.

Eventually both patients underwent the Sistrunk procedure, yielding definitive diagnosis and resolution of their symptoms.

Our cases serve as a reminder that for any cystic mass involving the hyoid bone, presentation in a very specific subset of adult patients may show physical exam findings that would lead to workup of an upper aerodigestive tract malignancy, however TGDC should be considered especially after imaging is thoroughly reviewed.

•Thyroglossal duct cysts can have an upward and ingrowing pattern in adult patients.•Two patients had symptoms that mimicked those of a throat mass prompting workup for an upper aerodigestive tract malignancy.•Further workup including computed tomography imaging revealed intralaryngeal and intralingual TGDCs in these patients.

Thyroglossal duct cysts can have an upward and ingrowing pattern in adult patients.

Two patients had symptoms that mimicked those of a throat mass prompting workup for an upper aerodigestive tract malignancy.

Further workup including computed tomography imaging revealed intralaryngeal and intralingual TGDCs in these patients.