Neck Lumps

Neck lumps treated by Dr Timothy Manzie, Sydney Oral Maxillofacial Surgeon Head Neck Surgeon

Thyroglossal duct cyst

A thyroglossal duct cyst is a fluid filled sac. It is a common cause for a painless swelling in the anterior neck. A thyroglossal duct cyst is a development cyst formed from cells of the thyroglossal tract, a pathway from the base of the tongue to the thyroid gland in the anterior neck. These cells would normally disappear but in some instances produce fluid causing the cyst.  They typically present in younger patients (under 30 years of age) and may become more obvious/prominent if secondarily infected. An infection usually presents with an increase in size of the swelling, overlying redness and heat of the skin as well as some pain and discomfort with swallowing. The thyroglossal duct cyst is typically removed by surgery with a procedure called a Sistrunk procedure.

Branchial cleft cyst

A branchial cleft cyst is a fluid filled sac. It is a common cause for painless swelling in the side of the neck (upper or lower end). A branchial cleft cyst in a development cyst formed from the cells of the branchial clefts, the cells that form a number of the critical structures in the head and neck region. These cells would normally disappear but in some instances produce fluid causing the cyst. They typically present in younger patients (under 30 years of age) and may become more obvious/prominent if secondarily infected. An infection usually presents with an increase in size of the swelling, overlying redness and heat of the skin as well as some pain and discomfort with swallowing. The branchial cleft cyst is typically removed by surgery.

Plunging ranula

A ranula is a fluid filled collection in the floor of mouth. A ranula is typically caused by a blocked or damaged salivary gland, whereby the fluid continues to be made but does not have a pathway to drain. These typically present with a painless blue swelling in the anterior floor of mouth (under the tongue). The plunging ranula is when the ranula extends through the muscles of the floor of the mouth and causes swelling in the anterior neck. Unlike the branchial cleft cyst or thyroglossal duct cyst it does not have a lining and is more prone to rupture either on its own (spontaneously) or during removal. A ranula may be managed with a procedure called micromarsupilisation (placement of a stitch under local anaesthetic) or surgery to remove the lump and all or part of the sublingual gland. A plunging ranula requires removal of the sublingual gland via the mouth.