Dr.Shobika,Dr.C Jayakumar,Dr.Praveena,Dr. Naveen
AIMS KOCHI
Four year old male child brought with complaints of recurrent episodes of fever and sub mental swelling that occasionally increases in size with pain.
Past history – No h/o previous hospital admissions
Birth history – 1st child of NCM
Antenatal history – uneventful
Natal history- Term/LSCS(NPL)/b.w-2kg/CIAB
Post natal history – uneventful
Development and immunization upto age.
Growth parameters were normal.
On examination,child is febrile with swelling in submental region 10 x 5cm,Tenderness+,
No local rise in temperature or erythema.
Systemic examination were within normal limits.
Differential diagnosis-midline neck masses and cystic neck masses
metastatic lymph nodes
dermoid or epidermoid cysts
second branchial cleft cysts.
Management- Surgical removal
Investigations showed neutrophilic leucocytosis with CRP-19.19mg/dl.
T4-5.1,TSH-4iu/ml
USG showed 11x6mm heteroechoic focus,to right of midline deep to sterno hyoid -stereo thyroid muscles soft tissue oedema suggestive of thyroglossal cyst.
Initially iv antibiotics were given ,no reduction in size of swelling so
Pediatric surgery consultation sought and child is taken up for thyroglossal cyst excision.
Intraoperative and postoperative period were uneventful.
The child is discharged with stable vitals.
Thyroglossal cyst:
Is a fibrous cyst that forms from a persistent thyroglossal duct.
It can be a irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland during developmental stages.
Incidence- usually age of 10yrs and younger
Causes- due to failure of closure of the thyroglossal duct extending from the foramen cecum in the tongue to the thyroid location in the neck.
Symptoms- A lymp in front of our throat
Swollen lymph nodes
Difficulty in swallowing
Tenderness
Swelling