: Midline Anterior Neck Inclusion Cysts (MANICs) are rare congenital anomalies
caused by improper embryonic fusion. These superficial benign lesions typically appear
yellowish and cystic without deeper anatomic connections. We describe an 11-month-old
boy with a stable, asymptomatic, yellow, elastic cystic lesion on the midline of the anterior
neck, measuring 4 mm and present since shortly after birth. Clinical, dermoscopic, and
ultrasound evaluations confirmed the diagnosis of MANIC. Over six months of
observation, the lesion remained stable without growth, infection, or symptoms. MANICs
are benign epidermoid cysts with minimal risk of complications that are often mistaken
for thyroglossal duct cysts, dermoid cysts, or other congenital anomalies. Unlike
thyroglossal duct cysts, they do not move during swallowing or tongue protrusion.
Management is usually conservative, with surgery reserved for symptomatic or
cosmetically significant cases. This case highlights the importance of parental reassurance
and avoiding unnecessary intervention for asymptomatic lesions. Recognition of
MANICs is essential for dermatologists and pediatricians evaluating midline neck lesions.
A conservative approach with regular monitoring ensures optimal care while minimizing
interventions. Further research may clarify the pathogenesis and long-term outcomes of
these rare lesions.