Q:

A 23 year old female presented with a swelling of her neck that moved upwards on protrusion of tongue. What is the next appropriate investigation?

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A 23 year old female presented with a swelling of her neck that moved upwards on protrusion of tongue. What is the next appropriate investigation?


  1. FNAC
  2. Punch biopsy
  3. Core biopsy
  4. MRI neck
  5. Radioactive thyroid scan

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The key is A. FNAC. [The diagnostic investigation of thyroglossal cyst is FNAC. Then we palpate for thyroid tissue. If absent we do any one of following to confirm the absence of thyroid tissue: ultrasonography, CT scanning, thyroid scanning or MRI. If there is normal thyroid tissue we go for more aggressive Sistrunk's operation but if there is no normal thyroid tissue [in that case thyroglossal cyst itself may be the only source of thyroid tissue] we do conservative surgery and preserve some portion of cyst with thyroid tissue].

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