A protruding mass under the laryngeal node is most commonly seen as a thyroglossal cyst, an enlarged lymph node in the front of the neck, or a swelling of the thyroid gland, and an ectopic thyroid gland. To differentiate between these conditions, an ultrasound of the neck is required. If the ultrasound reveals a cystic swelling in the front of the neck that is not related to the thyroid gland, most cases are considered to be thyroglossal cysts. A thyroglossal duct cyst, which is usually a congenital condition, is not obvious in the early stages. However, once infection or exudate within the cyst increases, swelling of the anterior aspect of the neck will occur and usually requires surgery. If an ultrasound is done and the swelling in front of the neck is found to be a lymph node and it is accompanied by sore throat or pneumonia. Consider applying the appropriate medication, and the swelling will gradually resolve. If a prominent swelling is found on the surface of the thyroid gland, or inside the thyroid gland when doing ultrasound, which is cystic or substantial, further CT of the neck is needed, or thyroid function tests are done. If you find no thyroid gland in front of the neck, but a separate substantial mass, be aware of whether it is an ectopic thyroid gland. An ectopic thyroid gland can easily be confused with other swellings.