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Indian Journal of Endocrinology and... Mar 2013
PubMed: 23776931
DOI: 10.4103/2230-8210.109695 -
Endocrinology, Diabetes & Metabolism... May 2020Lingual thyroid (LT) gland is the most common type of ectopic thyroid tissue, but it is an extremely rare presentation. We present a case of a 41-year-old Hispanic...
SUMMARY
Lingual thyroid (LT) gland is the most common type of ectopic thyroid tissue, but it is an extremely rare presentation. We present a case of a 41-year-old Hispanic female patient complaining of dysphonia and dysphagia. As part of the evaluation, fiber optic flexible indirect laryngoscopy (FIL) was performed which revealed a mass at the base of the tongue. The morphological examination was highly suspicious for ectopic thyroid tissue and the diagnosis was confirmed with neck ultrasound and thyroid scintigraphy. Although the patient presented subclinical hypothyroidism, levothyroxine therapy was initiated with a favorable response which included resolution of symptoms and mass size reduction. Our case portrays how thyroid hormone replacement therapy (THRT) may lead to a reduction in the size of the ectopic tissue and improvement of symptoms, thus avoiding the need for surgical intervention which could result in profound hypothyroidism severely affecting the patients' quality of life.
LEARNING POINTS
Benign LT and malignant LT are indistinguishable clinically and radiographically for which histopathology is recommended. THRT, radioactive iodine 131 (RAI) therapy, and surgical excision are potential management options for LT. THRT may lead to size reduction of the ectopic tissue and resolution of symptoms avoiding surgical intervention.
PubMed: 32478670
DOI: 10.1530/EDM-20-0026 -
European Annals of Otorhinolaryngology,... Apr 2016
Topics: Adult; Female; Humans; Lingual Thyroid
PubMed: 26474916
DOI: 10.1016/j.anorl.2015.09.008 -
Radiology Case Reports Jan 2023Lingual thyroid is by far the most common presentation of ectopic thyroid. Though mostly asymptomatic it is associated with congenital hypothyroidism and importantly,...
Lingual thyroid is by far the most common presentation of ectopic thyroid. Though mostly asymptomatic it is associated with congenital hypothyroidism and importantly, absence of orthotopic thyroid making it the only functional thyroid tissue a patient has in many cases. It appears indistinguishable to orthotopic thyroid tissue on imaging, with avid homogeneous enhancement on contrast computed tomography. Here we report clinical presentation and imaging findings of lingual thyroid in a 38-year-old man.
PubMed: 36388619
DOI: 10.1016/j.radcr.2022.10.039 -
Proceedings of the Royal Society of... 1912
PubMed: 19975978
DOI: No ID Found -
Srpski Arhiv Za Celokupno Lekarstvo 2007Lingual thyroid is a rare congenital malformation that occurs more frequently in the female population. It occurs because of the error in transcriptional factors, the...
Lingual thyroid is a rare congenital malformation that occurs more frequently in the female population. It occurs because of the error in transcriptional factors, the key for the normal differentiation of thyrocyte, so the thyroid gland tissue does not descend normally down the thyroglossal duct to the final position in the neck. Due to that, it can entirely or partially remain at the base of the tongue. This is the most frequent localization of the ectopic tissue while it can remain in the sublingual, suprahyoid and infrahyoid area as well. This disease can be diagnosed in the asymptomatic phase, as well as in the phase of compensatory and manifest hypothyroidism. In the ectopic thyroid gland, all diseases of the thyroid gland can occur as in the usual localization in the neck. The authors show a 6-year old patient, who had a routine medical examination for the inflamed throat, during which a vascular tumefaction was discovered at the base of the tongue. A cyst at the base of the tongue was suspected, but additional examination showed that it was an ectopic thyroid tissue marked as a lingual thyroid gland. Diagnosis of this disease starts with the laboratory analysis of the thyroid status. The next step involves scintigraphy of the thyroid gland with technetium-pertechnetate (99mTc) or radioactive iodine (123I). The therapy of the compensatory hypothyroidism is suppressive therapy with levothyroxine and in the manifest hypothyroidism it is hormone substitution therapy with levothyroxine. Although there are recommended age-related daily doses, they should not be accepted as final, but rather prescribed according to the individual thyroid status.
Topics: Child; Congenital Hypothyroidism; Female; Humans; Lingual Thyroid
PubMed: 17642462
DOI: 10.2298/sarh0704201m -
Thyroid : Official Journal of the... Apr 2016Lingual thyroid is a rare abnormality of thyroid development that is usually treated conservatively with levothyroxine replacement. Rarely, it becomes large enough to...
BACKGROUND
Lingual thyroid is a rare abnormality of thyroid development that is usually treated conservatively with levothyroxine replacement. Rarely, it becomes large enough to cause obstructive symptoms in the oral cavity, requiring definitive treatment.
PATIENT FINDINGS
This study reports on three patients with lingual thyroid treated with radioactive iodine-131 ((131)I) with successful radioablation of their ectopic thyroid tissues. Measurement of 24-hour radioactive iodine uptake within thyroidal tissues and hybrid single-photon emission computed tomography/computed tomography imaging using either iodine-123 or technetium-99m pertechnetate scans were performed in all patients demonstrating the location and size of lingual thyroid and absence of an orthotopic thyroid gland.
SUMMARY
The aim of this study was to describe nonsurgical management of obstructive lingual thyroid tissue with (131)I therapy for lingual thyroid radioablation. Patients were prepared with a low-iodine diet and levothyroxine withdrawal prior to radioablation for optimizing (131)I uptake in ectopic thyroid tissues. Hybrid single-photon emission computed tomography/computed tomography measurement of anatomic size of lingual thyroid tissue and radioactive iodine uptake guided the selection of therapeutic doses, resulting in administration of 10.7, 17.5, and 15.4 mCi of (131)I, respectively. There were no post-therapy complications, and clinical follow-up demonstrated resolution of obstructive oropharyngeal symptoms.
CONCLUSIONS
Ectopic lingual thyroid tissue is rarely associated with obstructive oropharyngeal symptoms due to progressive enlargement. Radioiodine therapy with (131)I is an effective treatment modality for ablation of ectopic thyroid tissue as an alternative to surgery.
Topics: Adult; Female; Humans; Iodine Radioisotopes; Lingual Thyroid; Middle Aged; Single Photon Emission Computed Tomography Computed Tomography; Sodium Pertechnetate Tc 99m; Thyroid Dysgenesis; Thyroid Gland; Thyroid Neoplasms; Thyroxine; Treatment Outcome; Young Adult
PubMed: 26864253
DOI: 10.1089/thy.2015.0396 -
Indian Journal of Otolaryngology and... Dec 2022Lingual thyroid is a very rare anomaly and is usually incidentally found in patients that have hypothyroidism or mass in throat. This case however had another mass in...
Lingual thyroid is a very rare anomaly and is usually incidentally found in patients that have hypothyroidism or mass in throat. This case however had another mass in the submandible with diagnosis of thyroglossal cyst. Thyroglossal duct cyst is the most common congenital neck mass. About 50% of cases present before the age of 10 and second group age present in young adulthood. We present a 27-year-old man who presented with sub-mental mass. The patient had also hypothyroidism. A CT scan was performed to confirm the diagnosis. The CT scan confirmed submental cyst and incidentally discovered lingual thyroid along with absence of thyroid tissue in its normal pretracheal position. The patient had symptoms of hypothyroidism and he was treated with levothyroxin. Our case report highlights a rare and unusual situation because of the coexistence of a thyroglossal cyst and a partially functional lingual thyroid.
PubMed: 36742619
DOI: 10.1007/s12070-021-02721-7