Epidermoid Cyst vs. Nodular Goiter
Left picture: The diagnosis is an epidermoid cyst of the jugular fossa. Right picture: A nodular goiter is the correct diagnosis. Useful for the differentiation of the two pathologies are, in addition to the local findings, the localization of the pathology (a jugular or a submental site is typical for an epidermoid cyst) and the age (a nodous goiter occurs most likely in a teenager, while an epidermoid cyst can already be seen in infancy). The aspect of the pathology with the diagnosis of a nodous struma could also fit the picture of a rare thyroglossal duct cyst at this unusual site, but not the findings on palpation.
In both children a median mass is visible in the lower half of the neck. Left picture: This pathology is much smaller than the mass in the contralateral picture, is roundish, situated in the jugular fossa and completely movable. Right picture: This pathology, too, is more likely solid, but some diffences of the consistence within the mass can be palpated; it lies higher, extends to the side, has irregular borders, and is movable as a whole only when swallowing.