A 35-year-old presents with a painless, compressible, transilluminable swelling in the anterior triangle of the neck that enlarges on Valsalva manoeuvre and on crying. The swelling does not move with swallowing or tongue protrusion. The MOST likely diagnosis based on these anatomical features is:
- A Thyroglossal cyst
- B Branchial cyst (second arch/pouch remnant)
- C Cystic hygroma (lymphatic malformation) ✓
- D Dermoid cyst
Explanation
Cystic hygroma (macrocystic lymphatic malformation) brilliantly transilluminates (thin-walled lymph-filled cysts), is soft and compressible, enlarges with Valsalva or crying (increased venous/lymphatic pressure), and does not move with swallowing because it has no thyroid or glossal attachment. Thyroglossal cysts move with swallowing and tongue protrusion because they are attached to the hyoid and thyroglossal tract. Branchial cysts appear in the anterior triangle but are not typically transilluminable and do not enlarge so markedly with Valsalva. Dermoid cysts are firm doughy swellings.
Reference: BD Chaurasia's Human Anatomy, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.