Midline neck swellings

Abstract Midline cervical swellings are most commonly benign and congenital in origin. They comprise a heterogeneous group of disorders in children. Lesions can often be diagnosed by careful history-taking and thorough physical examination alone. Most lesions will be thyroglossal cysts, but clinicians must be alert to other possibilities such as dermoid cysts and lymphadenopathy. Ectopic thyroid is a rare finding, but one that is important to recognize. Meticulous surgical technique is required to avoid most complications. Accurate clinical evaluation, supported by imaging when necessary, is key to effective diagnosis and surgical planning. The approach to clinical examination, investigation, and management of these common conditions is described.