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Current Medical Imaging 2021Embryologic developmental variants of the thyroid and parathyroid glands may cause cervical anomalies that are detectable in ultrasound examinations of the neck. For...
Embryologic developmental variants of the thyroid and parathyroid glands may cause cervical anomalies that are detectable in ultrasound examinations of the neck. For some of these developmental variants, molecular genetic factors have been identified. Ultrasound, as the first-line imaging procedure, has proven useful in detecting clinically relevant anatomic variants. The aim of this article was to systematically summarize the ultrasound characteristics of developmental variants of the thyroid and parathyroid glands as well as ectopic thymus and neck cysts. Quantitative measures were developed based on our findings and the respective literature. Developmental anomalies frequently manifest as cysts that can be detected by cervical ultrasound examinations. Median neck cysts are the most common congenital cervical cystic lesions, with a reported prevalence of 7% in the general population. Besides cystic malformations, developmental anomalies may appear as ectopic or dystopic tissue. Ectopic thyroid tissue is observed in the midline of the neck in most patients and has a prevalence of 1/100,000 to 1/300,000. Lingual thyroid accounts for 90% of cases of ectopic thyroid tissue. Zuckerkandl tubercles (ZTs) have been detected in 55% of all thyroid lobes. Prominent ZTs are frequently observed in thyroid lobes affected by autoimmune thyroiditis compared with normal lobes or nodular lobes (P = 0.006). The correct interpretation of the ultrasound characteristics of these variants is essential to establish the clinical diagnosis. In the preoperative assessment, the identification of these cervical anomalies via ultrasound examination is indispensable.
Topics: Humans; Neck; Parathyroid Glands; Thyroid Diseases; Ultrasonography
PubMed: 33504311
DOI: 10.2174/1573405617666210127162328 -
Acta Otorhinolaryngologica Italica :... Aug 2009Lingual thyroid is a rare embryological anomaly and originates from failure of the thyroid gland to descend from the foramen caecum to its normal eutopic pre-laryngeal... (Review)
Review
Lingual thyroid is a rare embryological anomaly and originates from failure of the thyroid gland to descend from the foramen caecum to its normal eutopic pre-laryngeal site. The ectopic gland located at the base of the tongue is often asymptomatic but may cause local symptoms such as dysphagia, dysphonia with stomatolalia, upper airway obstruction and haemorrhage, often with hypothyroidism. Two cases are presented, one in a 62-year-old female and the other in a 42-year-old female, both of whom complained of sensation of a foreign body and progressive dysphagia and dyspnoea caused by ectopic lingual thyroid. Treatment was performed with a partial endoscopic removal and an external cervical approach, followed by substitutive hormone treatment, respectively. Diagnostic procedures and therapeutic options are discussed and a review has been made of reports of lingual thyroid appearing in the literature.
Topics: Adult; Choristoma; Deglutition Disorders; Dysphonia; Dyspnea; Female; Humans; Lingual Thyroid; Middle Aged; Thyroid Gland; Tongue Diseases
PubMed: 20161880
DOI: No ID Found -
Internal Medicine (Tokyo, Japan) Oct 2002
Topics: Child; Choristoma; Female; Humans; Magnetic Resonance Imaging; Radiography; Radionuclide Imaging; Thyroid Gland; Thyroxine; Tongue Diseases; Treatment Outcome
PubMed: 12413023
DOI: 10.2169/internalmedicine.41.905 -
International Journal of Surgery Case... 2020Ectopia is the most common sporadically occurring thyroid heterotopy. We present three cases of ectopic thyroid tissue with compression of the upper aerodigestive tract....
INTRODUCTION
Ectopia is the most common sporadically occurring thyroid heterotopy. We present three cases of ectopic thyroid tissue with compression of the upper aerodigestive tract. The first case involved ectopic thyroid tissue in the lingual area of a 60-year-old male with dysphagia, swelling at the base of the tongue, and stomatolalia. The second case was a 66-year-old female with papillary thyroid carcinoma (PTC) in a thyroglossal duct cyst. The third patient was a 50-year-old female with aberrant thyroid tissue in the right submandibular region, with a cribriform-morular variant of PTC (CMV-PTC).
METHODS
After resecting the heterotopic tissue and verifying the presence of PTC, the second and third cases underwent total thyroidectomy, and the third patient also underwent radioactive iodine ablation (RAI). Postoperative athyreosis was compensated by permanent levothyroxine substitution.
RESULTS
The diagnosis of ectopic thyroid tissue is challenging. Clinical examination together with imaging methods play a key role, especially postoperative histological examination along with scintigraphy and single photon emission computed tomography (SPECT). Ultrasonography should be used to exclude normally localized thyroid tissue and to distinguish other tumorous diseases. In the pre-operative examination, ultrasound-guided fine-needle aspiration biopsy (US-FNAB) often results in technically-difficult sampling and non-diagnostic cytology.
CONCLUSION
Resection is the most suitable therapy for clinical symptoms of a foreign body in the upper aerodigestive tract and inflammatory complications; total thyroidectomy follows in case of malignant transformation. Thyroid heterotopy is a rare pathological condition, yet it should be taken into consideration during differential diagnosis of tumorous oropharyngeal and neck lesions.
PubMed: 31790949
DOI: 10.1016/j.ijscr.2019.11.011 -
International Journal of Surgery Case... 2018Mediastinal Ectopic Thyroid Gland is a rare entity, accounting for 1% of all mediastinal tumours. Here, we present a rare case of mediastinal mass that was proved to be...
INTRODUCTION
Mediastinal Ectopic Thyroid Gland is a rare entity, accounting for 1% of all mediastinal tumours. Here, we present a rare case of mediastinal mass that was proved to be an ectopic thyroid with normal thyroid function tests and normal thyroid gland in the cervical location.
CASE PRESENTATION
A 32-year-old lady had a road traffic accident, with the incidental discovery of a mediastinal mass on chest radiography. Thyroid function tests were normal. CT scans of the neck and chest revealed a large mediastinal mass compressing the trachea from the left side and extending to the superior part of the anterior mediastinum with normal thyroid gland in the cervical position. Midline Partial Sternotomy was done with complete surgical excision of the mass. It was well circumscribed, multinodular, had firm inconsistency, and grossly looked like a thyroid tissue. Histopathology revealed ectopic thyroid tissue negative for malignancy. Postoperative thyroid ultrasound showed normal thyroid lobes in the neck.
DISCUSSION
Ectopic thyroid tissue (ETT) occurs due to failure of the thyroid gland to migrate from foramen ceacum to its normal position in the cervical region in front of the trachea. The most common site of ETT is lingual thyroid and accounts for about 90% of all cases reported in the literature. ETT in the mediastinum is very rare, with only a few cases reported in the literature.
CONCLUSION
ETT in the mediastinum is very rare and can be associated with normal thyroid function and normal thyroid anatomical location. It should be differentiated from substernal goiter.
PubMed: 30292094
DOI: 10.1016/j.ijscr.2018.09.033 -
Medicina (Kaunas, Lithuania) Feb 2024: Typically, the external carotid artery (ECA) sends off separate anterior branches: the superior thyroid, lingual, and facial arteries. These could, however, form...
: Typically, the external carotid artery (ECA) sends off separate anterior branches: the superior thyroid, lingual, and facial arteries. These could, however, form common trunks: thyrolinguofacial, linguofacial (LFT), or thyrolingual. Although known, the LFT variant was poorly detailed previously, and most authors just counted the variant. We aimed to demonstrate the individual anatomical possibilities of the LFT on a case-by-case basis. : 150 archived angioCT files were used. After applying inclusion and exclusion criteria, 147 files of 86 males and 61 females were kept for this study. : In 34/147 cases, LFTs were found (23.12%). Bilateral LFTs were found in 13/34 cases (38.24%) and unilateral LFTs in 21/34 (61.76%) cases. Forty-seven LFTs were thus identified and further studied for different variables. Regarding the vertical topography of LFT origin, type 1a (suprahyoid and infragonial) was found in 28 LFTs (59.57%), type 1b (suprahyoid and gonial) was found in eight LFTs (17.02%), type 3 (suprahyoid and supragonial) was found in two LFTs (4.25%), type 2 (hyoid level of origin) in eight LFTs (17.02%), and type 3 (infrahyoid origin) in just one LFT (2.12%). Types of the initial course of the LFT were determined: type I, ascending, was found in 22/47 LFTs; type II, descending, in 12/47 LFTs; and type III, transverse, in 13/47 LFTs. Regarding the orientation of the first loop of the LFT, 23/47 LFTs had no loop, 4/47 had anterior loops, 1/47 had a posterior loop, 5/47 had superior loops, 5/47 had inferior loops, and 9/47 had medial loops. The position of the LFT relative to the ECA was classified as medial, anterior, or antero-medial. An amount of 12/47 LFTs were anterior to the ECA, 22/47 were antero-medial, 10/47 were medial, 2/47 were inferior, and 1/47 was lateral. Regarding their general morphology, 23/47 LFTs had a rectilinear course, 22/47 had loops, and 2/47 were coiled. A case-by-case presentation of results further demonstrated the diversity of the LFT. : In conclusion, the morphology and topography of the LFT are individually specific and unpredictable. It can be anticipated case-by-case by surgeons on CT or MR angiograms.
Topics: Male; Female; Humans; Carotid Artery, External; Thyroid Gland; Tongue; Arteries; Liver Function Tests
PubMed: 38399578
DOI: 10.3390/medicina60020291 -
Indian Journal of Otolaryngology and... Oct 2019Although lingual thyroid is the most common site for ectopic thyroid gland but carcinomas originating from lingual thyroid are extremely rare, accounting only for 1% of...
Although lingual thyroid is the most common site for ectopic thyroid gland but carcinomas originating from lingual thyroid are extremely rare, accounting only for 1% of all ectopic thyroids. Here we represent a young female with a bleeding mass at the base of her tongue and review the diagnostic approach towards papillary thyroid carcinoma of lingual thyroid. The surgical treatment and follow up are discussed. A combination of radiological studies and histological evaluation should be deployed to investigate suspicious lingual thyroids. The perspective of diagnostic and therapeutic approaches for carcinomas of lingual thyroid is the same as orthotopic thyroid tissue.
PubMed: 31742060
DOI: 10.1007/s12070-018-1539-5 -
International Journal of Surgery... 2014Ectopic thyroid tissue remains a rare developmental abnormality involving defective or aberrant embryogenesis of the thyroid gland during its passage from the floor of... (Review)
Review
Ectopic thyroid tissue remains a rare developmental abnormality involving defective or aberrant embryogenesis of the thyroid gland during its passage from the floor of the primitive foregut to its usual final position in pre-tracheal region of the neck. Its specific prevalence accounts about 1 case per 100.000-300.000 persons and one in 4.000-8.000 patients with thyroid disease show this condition. The cause of this defect is not fully known. Despite genetic factors have been associated with thyroid gland morphogenesis and differentiation, just recently some mutation has been associated with human thyroid ectopy. Lingual region in the most common site of thyroid ectopy but ectopic thyroid tissue were found in other head and neck locations. Nevertheless, aberrant ectopic thyroid tissue has been found in other places distant from the neck region. Ectopic tissue is affected by different pathological changes that occur in the normal eutopic thyroid. Patients may present insidiously or as an emergency. Diagnostic management of thyroid ectopy is performed by radionuclide thyroid imaging, ultrasonography, CT scan, MRI, biopsy and thyroid function tests. Asymptomatic euthyroid patients with ectopic thyroid do not usually require therapy but are kept under observation. For those with symptoms, treatment depends on size of the gland, nature of symptoms, thyroid function status and histological findings. Surgical excision is often required as treatment for this condition.
Topics: Genetic Predisposition to Disease; Head; Humans; Neck; Thyroid Dysgenesis; Thyroid Gland
PubMed: 24887357
DOI: 10.1016/j.ijsu.2014.05.076 -
Case Reports in Otolaryngology 2016Thyroglossal duct and lingual thyroid ectopic lesions are exceedingly rare synchronous findings. Papillary thyroid carcinoma of these ectopic thyroid sites is well...
Thyroglossal duct and lingual thyroid ectopic lesions are exceedingly rare synchronous findings. Papillary thyroid carcinoma of these ectopic thyroid sites is well understood but still a rare finding. This case points to some management nuances in regard to ectopic thyroid screening with imaging and also shows the effectiveness of minimally invasive transoral robotic surgery for lingual thyroid.
PubMed: 27119036
DOI: 10.1155/2016/3975924 -
The Malaysian Journal of Medical... 2015Ectopic lingual thyroid is a rare developmental anomaly. It is caused by aberrant embryogenesis during the thyroid descent to the neck. It may remain asymptomatic or...
Ectopic lingual thyroid is a rare developmental anomaly. It is caused by aberrant embryogenesis during the thyroid descent to the neck. It may remain asymptomatic or present with dysphagia, hemoptysis, dyspnoea or dysphonia. Clinically, it presents as a mass lesion on the base of the tongue. The most important diagnostic tool for an ectopic lingual thyroid is the 99mTc radionuclide scan, but imaging modalities such as computed tomography scan and magnetic resonance imaging may also help to assess its location and extent and to rule out the presence of normal thyroid tissue in the thyroid bed. The management of an ectopic thyroid remains controversial. No treatment is required for asymptomatic patients in the euthyroid state. Patients with hypothyroidism should be treated with thyroid hormone substitution therapy. Malignant transformation is an indication for complete surgical resection. Ablative radioiodine therapy can be considered for older patients and those who are unfit for surgery. In complicated cases, surgical resection is recommended through the transoral, transhyoid or lateral pharyngectomy approach. We report a case of ectopic lingual thyroid in a 35-year-old man who presented with nasal twang and hemoptysis.
PubMed: 26023300
DOI: No ID Found