# Clinical Hypothyroidism Following Sistrunk Procedure: A Diagnostic Pitfall

## TL;DR

A patient developed hypothyroidism after a Sistrunk procedure, highlighting the need for thorough pre-surgical evaluation to avoid misdiagnosis.

## Contribution

Highlights the diagnostic challenges and importance of multidisciplinary evaluation in thyroid-related surgeries.

## Key findings

- The patient developed primary hypothyroidism after a Sistrunk procedure.
- Further evaluation revealed the correct diagnosis of ectopic thyroid.
- Comprehensive pre-surgical assessment can reduce morbidity and improve outcomes.

## Abstract

The differential diagnosis of an anterior neck mass is extensive and may encompass benign or malignant tumors. Most cases are due to congenital malformations, inflammation/infection, or neoplastic conditions. A proper diagnostic approach is essential to ensure adequate management and follow-up. We report the case of a 43-year-old woman referred to our outpatient clinic due to a painless anterior neck mass. Initial clinical and imaging assessment was consistent with a thyroglossal duct cyst, and a Sistrunk procedure was proposed. Clinical and imaging findings suggestive of recurrence led to surgical reintervention 23 months later. Unexpectedly, the patient developed primary hypothyroidism postoperatively, prompting revision of the initial diagnosis. Further imaging studies and subsequent multidisciplinary evaluation led to the correct diagnosis of ectopic thyroid. This case emphasizes the importance of comprehensive laboratory and thorough neck imaging evaluation within a multidisciplinary setting in every case prior to any thyroid-related surgical proposals. Such an approach could reduce morbidity and improve clinical outcomes in these patients.