Question about cyst

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Guest

Guest
Hey guys I've been a long time reader of these forums and I have an odd situation and am seeking advice.

I noticed a lump in my neck and after seeing an ENT and such I have a thyroglossal duct cyst. They are benign 99% of the time. I was told I don't really have to do anything however the only treatment is to have it surgically removed.

Is this something I have to declare on a medical? would it be ok to just let it be in terms of getting a renewed medical? Or would an AME need to see it taken out since there's like a 1% chance it could be malignant? There's really no way to prove its benign except for surgery but it's rare is what they said. Thanks for thoughts and I prefer not to have the surgery as it'll leave a noticeable scar for everyone to see :/
 
Guest said:
Hey guys I've been a long time reader of these forums and I have an odd situation and am seeking advice.

I noticed a lump in my neck and after seeing an ENT and such I have a thyroglossal duct cyst. They are benign 99% of the time. I was told I don't really have to do anything however the only treatment is to have it surgically removed.

Is this something I have to declare on a medical? would it be ok to just let it be in terms of getting a renewed medical? Or would an AME need to see it taken out since there's like a 1% chance it could be malignant? There's really no way to prove its benign except for surgery but it's rare is what they said. Thanks for thoughts and I prefer not to have the surgery as it'll leave a noticeable scar for everyone to see :/
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Get it removed. The scar isn't bad if the surgeon is competent. My son had one removed as an infant. Reducing cancer risk and getting rid of the cyst is worth having a scar. In my humble, common sense and not a doctor opinion.
 
Wear a turtle neck sweater when you go for your medical so the AME doesn't notice it. Coverup and denial are always best when it comes to medical issues.
 
As for your medical, the doctor who removes it will almost certainly send it out for a path report. If it comes back benign, you report that on your next medical. It's a yawner. I've had such cysts removed before.

If you chose not to remove it, you may want to at least have a biopsy to show that it's benign. Probably can be done with an ultrasound-guided fine needle aspiration. Again, a benign path report is going to be a yawner.
 
If your ENT recommends not removing it as the chance of cancer is remote, then if it were me I would likely follow that recommendation. Are you eligible to fly under BasicMed? Given what you have said it is unlikely that a PCP or AME would refuse to sign you off because of that kind of a cyst. If you need a 3rd or higher class though, not sure about the FAA. Hopefully Bruce (Dr. Bruce Chien) will see this and chime in; or you can take the initiative and contact him privately at www.aeromedicaldoc.com.
 
I know someone who had one of these. She didn't want it removed because she didn't believe in unnecessary surgery. It slowly went away on its own after a few years. This person was not a pilot so I have no idea if it would affect your medical, but I don't think she had any adverse symptoms.
 
Hey guys thanks for the replies. Basically the ENT said its my choice, the chance of malignancy is remote. But I'm like not sure if this is something that is a "condition" or whatnot that I need to tell the AME about. It's non painful, not very noticeable, however like I said like 1 % of cases turn up malignant. He didn't really seemed concerned. Just something I report on the next medical? My AME said something last visit to "let him know about any surgery right after they happen" which goes against what most people say as if the doctor clears you after a small surgery you just report on the next medical.
 
Guest said:
the ENT said ... Just something I report on the next medical? My AME said something last visit to "let him know about any surgery right after they happen" .
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You visited an ENT doctor, so you report it at your next medical.

If you choose to visit the doctor again for the surgery, you should report that (and the outcome) also at the next medical.

I think you are asking if you should report the minor surgery to your AME or FAA aeromedical sooner, before your next medical? I'm pretty sure that for a minor surgery that cannot affect your safety of flight the answer is "no".

Here's something from an FAA FAQ page:

"Am I prohibited from exercising the privileges of my pilot certificate during medical deficiency?
Yes. You are prohibited from acting as pilot-in-command or as a required pilot flight crewmember during any medical deficiency that would be disqualifying or may interfere with the safe operation of an aircraft.
For more information, see 14 CFR §61.53
A simple problem such as a cold, a broken arm, or an abscessed tooth may require nothing more than the appropriate treatment and a little time before you can safely return to the skies. A more complicated problem or the development or change of a chronic illness may necessitate consultation with an AME or the FAA before resuming flying. New medical conditions do not need to be reported to the FAA until you wish to return to flying."
 
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And here is 61.53:

§61.53 Prohibition on operations during medical deficiency.
(a) Operations that require a medical certificate. Except as provided for in paragraph (b) of this section, no person who holds a medical certificate issued under part 67 of this chapter may act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person:

(1) Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or

(2) Is taking medication or receiving other treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation.
 
I don't know about that type of cyst but I had a couple of benign polyps removed during a colonoscopy and my AME was not concerned at all. However if they had not been removed and biopsied to determine they were benign, different story.
 
I guess my question kind of is, imwhat am I supposed to do with a "watch and waits plan? Cancer is a disqualifying condition, but what does the FAA say about something that "could" be cancer but hasn't affected one adversely and the doctor recommends just watching what happens? Does that call for self grounding? Does anyone have any experience with a similar situation?
 
bbchien said:
As long as it is not causing problems this is an AME yawn. :)
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It isn't causing me any problems. So should i tell the AME about it now? Wait until the next medical? Self ground? or just report it on the next medical
 
Guest said:
Does that call for self grounding?
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61.53 says you should self ground for "any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation;"

I don't think that applies here, because the #1 AME expert, Dr. Chien, just said that if it isn't causing problems, your condition would not pose an issue for the medical certificate.
 
Guest said:
I guess my question kind of is, imwhat am I supposed to do with a "watch and waits plan? Cancer is a disqualifying condition, but what does the FAA say about something that "could" be cancer but hasn't affected one adversely and the doctor recommends just watching what happens? Does that call for self grounding? Does anyone have any experience with a similar situation?
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Dr. Chien is the final word with respect to the FAA. (Well I mean on this forum on the subject of the FAA.) If it's a yawn, don't even worry about it. Report the visit, but no need to point out that there's a 1% chance of it being malignant. It's not an issue until it's an issue. Look at it this way, I have a 14% chance of getting breast cancer just because I'm female and the FAA doesn't worry about it until I actually do.

But aside from the FAA, I like flyingron's suggestion to ask the ENT if a fine needle aspiration would be justified. But that's just me. I have a thing about lumps in the neck.
 
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