ABSTRACT
A 48-year-old man diagnosed with rheumatoid arthritis was treated with methotrexate for 10 years. He presented left tonsil ulceration and ipsilateral cervical lymphadenopathy. A tonsillar biopsy revealed tuberculosis. The patient received antituberculous therapy for 8 months with a positive response. However, after resumption of methotrexate due to worsening rheumatoid arthritis, symptoms recurred. The patient initiated antituberculous therapy once more for 6 months, and methotrexate was stopped. At regular follow-up, the patient showed a positive clinical response with resolution of tonsillar ulceration and lymphadenopathy after 14 months of antituberculosis treatment.
ABSTRACT
INTRODUCTION: Thyroglossal duct cysts (TDCs) can be detected in several different locations, although in the literature, intrathyroidal presentations are rare. CASE PRESENTATION: Our patient was a 56-year-old woman who was diagnosed with hypothyroidism and presented with a right-lateral neck mass that was clinically indistinguishable from a thyroid nodule. Cytology revealed normal-looking squamous cells on fine-needle aspiration. Right hemithyroidectomy was performed, and histopathological examination revealed a cyst lined by squamous epithelium that was consistent with a thyroglossal duct cyst (TDC). DISCUSSION: Our recommendation is to diagnose intrathyroid thyroglossal duct cyst (ITTDC) in front of anterior basicervical masses, particularly when the patient has hypothyroidism. Fine needle aspiration cytology can be used to detect benign squamous cells and may rule out malignancy. CONCLUSION: Although relatively rare, an intrathyroid thyroglossal duct cyst (ITTDC) is a benign lesion whose diagnosis must be correctly established for appropriate therapeutic management.
