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Tracheal Cyst Presenting as a Potential Recurrent Thyroid Malignancy

Burt A, Johnson M, Lydiatt W and Goldner W

Background: Tracheal cysts are rare and usually present in children. The most common explanation for the etiology of these cysts suggests a congenital malformation due to ventral foregut folding. Tracheal cysts are typically not of great consequence to patients, however in many instances it is recommended that they be removed.

Methods: A chart review of a single patient was performed.

Results: A 35 year-old female with cystic fibrosis and a history of medullary thyroid cancer status post thyroidectomy and central neck dissection was found to have two hypoechoic nodules in the thyroid bed 21 months after surgery. Fine-needle biopsy showed pseudostratified ciliated epithelium in one nodule and a CT scan identified a previously absent tracheal cyst. Because the patient had undergone previous neck imaging for her preexisting conditions, it is known that her cyst developed post thyroidectomy.

Conclusion: The development of the tracheal cyst may be related to her other conditions and history of surgery although this is not possible to definitively prove. Development of hypoechoic ultrasound lesions in a patient with thyroid carcinoma can be worrisome. There are no similar reported cases in the literature and the clinician should remain aware of unusual masses presenting in the thyroid bed after thyroid carcinoma resection that may mimic recurrent thyroid carcinoma.