An anterior neck swelling may represent a thyroglossal duct cyst or ectopic thyroid tissue. Resection of ectopic thyroid tissue may render the patient permanently hypothyroid with a lifelong need for thyroid hormone replacement. The authors are from Children's Hospitals in Boston and Cleveland.
A patient who has an ectopic thyroid gland and marginal thyroid hormone production may develop a goiter in the gland remnant, which may appear as an anterior neck swelling.
Indications for performing a thyroid scan to identify thyroid tissue:
(1) clinically hypothyroid
(2) elevated TSH
(3) infant or young child (due to the difficulty in the palpating the thyroid)
(4) failure to detect a palpable thyroid in the normal anatomic location
In general a thyroid scan should be done if there is any doubt prior to removing a potential thyroglossal duct cyst.
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