The following statements about thyroglossal cyst are true, except
**Core Concept**
A thyroglossal cyst is a congenital anomaly that results from the remnants of the thyroglossal duct, which is an embryological structure that forms during the development of the thyroid gland. These cysts typically present as anterior midline neck masses and can be associated with a variety of symptoms.
**Why the Correct Answer is Right**
The treatment of choice for a thyroglossal cyst is a Sistrunk procedure, which involves the complete excision of the cyst, the central portion of the hyoid bone, and the tract leading from the hyoid bone to the foramen cecum. This procedure is more effective than simple incision and drainage in preventing recurrence. **Option C** is incorrect because incision and drainage may lead to incomplete removal of the cyst and a higher likelihood of recurrence.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is true, as thyroglossal cysts are a frequent cause of anterior midline neck masses in the first decade of life. They typically present in children, with a peak incidence between 2 and 8 years of age.
**Option B:** This option is a characteristic feature of thyroglossal cysts. They are usually located within 2 cm of the midline and can be associated with a midline neck mass that moves upwards on protrusion of the tongue.
**Option D:** This option is also true, as the thyroglossal duct cysts are often attached to the foramen cecum (the point where the tongue develops) and therefore move upwards on protrusion of the tongue.
**Clinical Pearl / High-Yield Fact**
It is essential to remember that a thyroglossal cyst can be associated with a thyroglossal duct cyst fistula, which may present as a persistent neck mass or sinus tract. A detailed history and examination are crucial in diagnosing and managing these cases.
**✓ Correct Answer: C. Incision and drainage is the treatment of choice**