A 14-year-old girl has a midline neck swelling that elevates on protrusion of the tongue and moves with swallowing. It has developed a sinus tract after repeated infections. The embryological basis of this lesion is persistence of:
- A The thyroglossal duct (remnant of the thyroid's descent from the foramen caecum) ✓
- B Second pharyngeal pouch
- C The first pharyngeal cleft
- D The cervical sinus of His
Correct answer: A. The thyroglossal duct (remnant of the thyroid's descent from the foramen caecum)
Explanation
A thyroglossal duct cyst arises from persistence of the thyroglossal duct, the embryonic tract along which the thyroid gland descends from the foramen caecum of the tongue to its pretracheal position. Because the tract passes through or around the hyoid bone, the cyst characteristically moves upward with tongue protrusion. Sistrunk operation (removal of the cyst, tract, and central hyoid bone) is the standard surgical treatment to prevent recurrence.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.