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Abstract

Case presentation: A 67-year-old man with multiple myeloma was referred for abnormal hormone levels, which were ultimately attributed to hypopituitarism due to a nonfunctioning pituitary macroadenoma. On the initial physical examination, a 4-cm midline neck mass that moved cranially with swallowing and tongue protrusion was identified (Fig. 1). The patient denied dysphagia, dysphonia, dyspnea, stridor, or neck tenderness and recalled that the mass had been present since childhood. Post-contrast axial views from a computed tomography scan of the neck revealed a cystic lesion anterior to the thyroid cartilage (Fig. 2a) and extending between the thyroid cartilage notch and the hyoid bone (Fig. 2a) into the preepiglottic space posterior to the hyoid bone (Fig. 2a). In retrospect, the lesion could be identified on a magnetic resonance imaging (MRI) scan of the cervical spine obtained 7 years prior and had similar dimensions and extension. There was no change in size or development of symptoms related to the mass after 3 years of follow-up. What is the diagnosis?