Cavernous hemangioma within a thyroglossal duct cyst

Thyroglossal duct cysts (TDCs) are the most common developmental abnormality of the neck, accounting for 70-75% of midline neck masses in children. Less commonly, TDCs can present in adulthood. Hemangioma is another benign tumor that can be found in the head and neck and commonly presents in children; it is rarely found in adults. We report a case of a 73-year-old patient who was found to have an asymptomatic TDC identified on CT imaging that subsequently showed increased size and nodular foci. Fine-needle aspiration biopsy was concerning for malignant transformation, which prompted Sistrunk surgical resection. Histopathological examination revealed benign pathology of the TDC and the presence of a cavernous hemangioma arising from within the TDC. The patient had an uneventful post-operative course.