Surgical Removal of Rheumatoid Nodule That Presented as a Thyroglossal Duct Cyst: A Case Report.
Jacob M Tupa, Jace R Otremba, Mark D Strand
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Case in brief
A 63-year-old woman with a history of lung and kidney cancer presented with left submandibular neck pain, a lesion that appeared on imaging to be a thyroglossal duct cyst, and joint pain. After workup that included PET and CT, the lesion was removed by Sistrunk procedure. Histopathology identified a rheumatoid nodule. She had not previously been diagnosed with rheumatoid arthritis; following excision, rheumatology evaluated her and she was treated for RA.
What made this case unusual
A presumed thyroglossal duct cyst proved to be a rheumatoid nodule, and its removal preceded the patient’s RA diagnosis.
Diagnostic / clinical pearl
When evaluating a neck mass, consider accompanying joint symptoms alongside imaging findings; pathology may reveal a systemic disease not previously diagnosed.
Why it matters
The report underscores the value of communication between otolaryngology, pathology, and rheumatology when a lesion’s pathology and the patient’s broader symptoms point beyond a local neck diagnosis.