Clinical Report: A Case Study of a Large Thyroglossal Duct Cyst Inducing Hoarseness

Overview

This report details a rare case of a giant thyroglossal duct cyst (TGDC) in a 65-year-old man, presenting with hoarseness due to laryngeal compression. Surgical excision led to resolution of symptoms, highlighting the importance of recognizing TGDCs in older adults.

Background

Thyroglossal duct cysts are common congenital neck anomalies, typically presenting in childhood. Their occurrence in elderly patients is rare, with only about 0.6% of cases reported in individuals over 60 years. This case emphasizes the need for awareness and careful diagnostic evaluation of neck masses in older adults.

Data Highlights

Preoperative imaging revealed a giant cystic-solid midline cervical lesion compressing the larynx. Histopathological examination confirmed TGDC with old hemorrhage and cholesterol crystal formation.

Key Findings

• The patient had a 2-year history of a midline neck mass with progressive enlargement.
• Symptoms included hoarseness, phonation difficulty, and swallowing obstruction.
• Preoperative imaging showed compression and narrowing of the laryngeal cavity.
• Surgical excision based on the Sistrunk principle resulted in symptom resolution.
• Histopathology confirmed the diagnosis of TGDC.

Clinical Implications

This case illustrates the potential for TGDCs to present with atypical symptoms such as hoarseness in older adults. Clinicians should consider TGDC in the differential diagnosis of neck masses in this age group.

Conclusion

The presentation of a giant TGDC in an elderly patient underscores the importance of thorough evaluation of neck masses and the effectiveness of surgical intervention in resolving compressive symptoms.

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