56 year old gentleman presented with midline neck swelling recently noticed.
CT (contrast enhanced)
Midline neck cystic lesion with smooth uniform thickness wall having a suprahyoid and infrahyoid component. Suprahyoid component extends into the left sublingual space inferior to the mylohyoid deep to the anterior belly of digastric. Infrahyoid it lies immediately beneath and in contact with body of hyoid, breaching the thyrohyoid and ventrally impinging on the laryngopharynx. no internal septae or enhancing mural nodules seen in the lesion. No communication with the airway.
70% of midline cystic neck swellings are accounted for by thyroglossal duct cysts that share a good relation with the hyoid bone. When a suprahyoid component with suspicious communication with sublingual space is identified, possibility of plunging ranula has to be considered.