History:

Thyroglossal duct cysts always occur on the anterior portion of the neck, near the hyoid bone. They present as a sinus, cyst or recurrent abscess. They are the most common cause of congenital neck anomalies in childhood, however presentation in adult life can occur. Clinically, thyroglossal duct cysts are deep to subcutaneous tissue. This patient had an asymptomatic, rounded, small cyst appeared in the midline of the neck since early childhood. Now he presents with an inflamed slightly tender cystic swelling with a band connecting the cyst to deeper structures felt as cord-like structure on palpation. Please note the nearby scar due to previous surgical drainage of a complicating abscess many years ago.