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Indian Journal of Nuclear Medicine :... Apr 2012Thyroid ectopy is characterized by the presence of thyroid tissue outside its normal position resulting from a defect of the thyroid diverticulum migration from the base...
Thyroid ectopy is characterized by the presence of thyroid tissue outside its normal position resulting from a defect of the thyroid diverticulum migration from the base of the tongue until its final pre-tracheal position. One case is presented in a 12-year-old girl patient who consults for a failure to thrive estimated at less than three standard deviations (SD). Bone age was estimated at 8 years late compared to chronological age. The hormonal assessment showed hypothyroidism with negative thyroid antibodies. Cervical ultrasound was revealed thyroid parenchyma pre-dominantly left in place while sweeping the area under chin showed a nodular formation of the base of the tongue. Thyroid scan with technetium 99 m showed a selective uptake of radiotracer in sublingual position. Cervical computed tomography revealed a posterior median sublingual mass spontaneously hyperdense and enhancing sharply after injection of contrast. Treatment with thyroxine allowed obtaining euthyroidism. This case asks us to be careful before aetiological diagnosis of hypothyroidism in children, because although this is rare, the presence of a thyroid parenchyma up to the cervical ultrasound does not eliminate the presence of ectopic tissue.
PubMed: 23723588
DOI: 10.4103/0972-3919.110718 -
Endocrinology, Diabetes & Metabolism... 2018We report a case of a 15-year-old girl with a midline neck mass that was first noted 2 or 3 years previously. She had been treated with levothyroxine (L-T4) for...
UNLABELLED
We report a case of a 15-year-old girl with a midline neck mass that was first noted 2 or 3 years previously. She had been treated with levothyroxine (L-T4) for congenital hypothyroidism until 11 years of age. Ultrasonography revealed an atrophic right thyroid (1.0 × 1.6 × 2.6 cm in size) and a mass (2.3 × 1.0 × 3.5 cm in size) in the upper part of the neck. No left lobe of the thyroid was detected. On further evaluation, Tc-99m pertechnetate thyroid scintigraphy and CT showed ectopic thyroid tissue in the lingual region and infrahyoid region. Thus, she was diagnosed as having dual ectopic thyroid and thyroid hemiagenesis. The atrophic right thyroid was thought be non-functional. Treatment with L-T4 was started to reduce the size of the dual ectopic thyroid tissue. This may be the first reported case of dual ectopic thyroid associated with hemiagenesis detected only by ultrasonography.
LEARNING POINTS
Ultrasonography can confirm the presence or absence of orthotopic thyroid tissue in patients with ectopic thyroid.The cause of congenital hypothyroidism should be examined.Clinical manifestation of ectopic thyroid may appear when the treatment with L-T4 is discontinued.Annual follow-up is needed in all children when their thyroid hormone replacement is stopped.
PubMed: 29732163
DOI: 10.1530/EDM-18-0026 -
Ear, Nose, & Throat Journal Mar 2024Lingual thyroid is an uncommon condition and cases accompanying thyroid hemiagenesis are rarely documented. Patients with thyroid hemiagenesis are usually asymptomatic...
Lingual thyroid is an uncommon condition and cases accompanying thyroid hemiagenesis are rarely documented. Patients with thyroid hemiagenesis are usually asymptomatic and generally diagnosed incidentally. Herein, we reported the case of thyroid hemiagenesis accompanying an ectopic lingual thyroid with euthyroidism and presented with regional symptoms.
Topics: Humans; Lingual Thyroid; Thyroid Dysgenesis; Tongue
PubMed: 34525880
DOI: 10.1177/01455613211036229 -
International Journal of Surgery Case... May 2021Having two or more sites of simultaneous ectopic thyroid tissue is a rare phenomenon. Thyroid ectopia should be considered in congenital hypothyroidism where no eutopic...
INTRODUCTION AND IMPORTANCE
Having two or more sites of simultaneous ectopic thyroid tissue is a rare phenomenon. Thyroid ectopia should be considered in congenital hypothyroidism where no eutopic thyroid gland is found.
CASE PRESENTATION
This case describes an incidental finding of dual ectopic thyroid tissue on computer tomography scan in an adult with known congenital hypothyroidism that was previously attributed to thyroid agenesis. The decision was made to proceed with a Sistrunk procedure to excise the ectopic submental thyroid as it became more noticeable after weight loss following bariatric surgery, and to monitor the remaining lingual thyroid with a combination of clinical symptomology, imaging and thyroid function studies given its challenging location.
CLINICAL DISCUSSION
The literature on pathophysiology, imaging modalities, and common considerations for surgical extirpation is reviewed.
CONCLUSION
The utility of thyroid scintigraphy may be limited in patients with known thyroid ectopia; other investigative modalities are helpful. The Sistrunk procedure was used to excise an ectopic thyroid, based on its embryological migration from the foramen caecum to the usual pretracheal position along the thyroglossal tract, and is a suitable technique for excision of submental thyroid tissue causing an unsightly mass and where thorough histopathological examination is required to exclude malignancy.
PubMed: 33957400
DOI: 10.1016/j.ijscr.2021.105909 -
Medicine Oct 2021Ectopic thyroid tissue presenting at the base of the tongue, called lingual thyroid, is a clinical rarity. Clinical presentation varies depending upon either the...
INTRODUCTION
Ectopic thyroid tissue presenting at the base of the tongue, called lingual thyroid, is a clinical rarity. Clinical presentation varies depending upon either the severity of regional symptoms associated with the enlargement of gland size, or the features related to thyroid dysfunction.
PATIENT CONCERNS
We reported a case of a 29-year-old female who presented with symptoms of easy fatigue and depression for 3 months.
DIAGNOSIS
After a series of diagnostic workup, the lingual thyroid with severe hypothyroidism was diagnosed.
INTERVENTION AND OUTCOME
She received conservative treatment with thyroid hormone replacement and the symptoms improved significantly.
LESSONS
Lingual thyroid is a rare entity that needs careful diagnostic workup including clinical examination, biochemical tests, imaging methods such as ultrasonography, scintigraphy, computed tomography, magnetic resonance imaging, and fine-needle aspiration cytology to plan the management. Lingual thyroid with hypothyroidism and no neck regional symptoms can be conservatively treated and requires regular follow-up for the prevention of potential risk of malignant transformation.
Topics: Adult; Female; Humans; Hypothyroidism; Lingual Thyroid; Thyroid Hormones
PubMed: 34713843
DOI: 10.1097/MD.0000000000027612 -
Cureus May 2023Background Thyroglossal tract anomalies are the most common cause of midline neck swelling. Thyroglossal cysts present between the base of the tongue and cricoid...
Background Thyroglossal tract anomalies are the most common cause of midline neck swelling. Thyroglossal cysts present between the base of the tongue and cricoid cartilage as painless, midline swelling that moves on deglutition and protrusion of the tongue. If the thyroglossal cyst gets infected or is violated surgically, it can result in a thyroglossal sinus or fistula. Investigations in patients with suspected thyroglossal cysts include a thyroid function test, ultrasonography of the neck, and fine needle aspiration cytology (FNAC). Computed tomography (CT) or magnetic resonance imaging (MRI) can be done for larger cysts or suspected malignancies. The gold standard treatment is Sistrunk surgery. Recurrence rates with Sistrunk surgery are lower when the surgery is performed accurately. This study was conducted to document the clinical presentation and treatment outcome in patients treated for thyroglossal tract anomalies. Methods This is a retrospective analysis of 46 medical case records of patients operated on for thyroglossal tract anomalies at a rural tertiary care hospital from April 1995 to April 2021. Patients fulfilling the inclusion and exclusion criteria were evaluated with a detailed history, various clinical presentations, location, extent of anomalies, and thyroid function test results documented. Ultrasound images were reviewed, and the findings were documented. All patients have consent, and they underwent Sistrunk surgery. Patients in whom the normal thyroid gland was found to be absent were started on replacement thyroxine after surgery. The specimen was subjected to histopathological examination by a senior pathologist. The outcome regarding complications, recurrence, and further treatment were reviewed. The outcome of the thyroglossal fistula was compared with that of thyroglossal cysts, and the outcome of infrahyoid thyroglossal tract anomalies was compared with that of suprahyoid thyroglossal tract anomalies. Results In this study, among the 46 patients, 24 (52.2%) were female and 22 (47.8%) were male. The minimum age was three years, the maximum was 58, and the mean was 20.6 years. In this study, 71.7% of the patients were diagnosed with thyroglossal cysts, 10.9% had thyroglossal fistulas, and two had lingual thyroids. The most common location of the cyst was infrahyoid (73.9%). 44 patients underwent Sistrunk surgery, and two patients diagnosed with lingual thyroid underwent excision. Three patients had complications (two pharyngo-cutaneous fistulas, one wound dehiscence), and all were managed conservatively. There were no recurrences in our study. Conclusion Thyroglossal tract anomalies are the most common congenital cervical anomalies. A complete Sistrunk procedure includes the removal of the entire thyroglossal tract, inclusive of the body of the hyoid bone along with the cuff of base tongue tissue, and gives the best result for thyroglossal tract anomalies.
PubMed: 37351250
DOI: 10.7759/cureus.39325 -
Case Reports in Otolaryngology 2015Lingual thyroid gland is a rare clinical entity. The presence of an ectopic thyroid gland located at the base of the tongue may be presented with symptoms like...
Lingual thyroid gland is a rare clinical entity. The presence of an ectopic thyroid gland located at the base of the tongue may be presented with symptoms like dysphagia, dysphonia, and upper airway obstruction. We are introducing a case of an 8-year-old girl who had lingual thyroid that presented dysphagia and foreign body sensation in the throat. The diagnostic was reached with clinical examination, thyroid scintigraphy with Tc(99m) and ultrasound. A laryngoscopy was performed which confirmed a spherical mass at base of tongue. Investigation should include thyroid function tests. In this case we observed subclinical hypothyroidism. There are different types of surgical approaches for the treatment of this condition; however, the treatment with Levothyroxine Sodium allowed the stabilization of TSH levels and clinical improvement of symptoms in a follow-up of 2 years.
PubMed: 25785216
DOI: 10.1155/2015/265207 -
Case Reports in Otolaryngology 2015Ectopic thyroid gland may be detected at any place between foramen caecaum and normal thyroid localization due to inadequacy of the embryological migration of the...
Ectopic thyroid gland may be detected at any place between foramen caecaum and normal thyroid localization due to inadequacy of the embryological migration of the thyroid gland. It has a prevalence varying between 1/10.000 and 1/100000 in the community. Usually follow-up without treatment is preferred except for obstructive symptoms, bleeding, and suspicion of malignity. Main symptoms are dysphagia, dysphonia, bleeding, dyspnea, and obstructive sleep apnea. In symptomatic cases, the first described method in surgical treatment is open approach since it is a region difficult to have access to. However, this approach has an increased risk of morbidity and postoperative complications. Transoral robotic surgery, which is a minimally invasive surgical procedure, has advantages such as larger three-dimensional point of view and ease of manipulation due to robotic instruments. In this report, a case at the age of 49 who presented to our clinic with obstructive symptoms increasing within the last year and was found to have lingual thyroid and underwent excision of ectopic thyroid tissue by da Vinci surgical system is presented.
PubMed: 26064746
DOI: 10.1155/2015/548582 -
Journal of Family Medicine and Primary... Mar 2019Lingual thyroid is an abnormal mass of ectopic thyroid tissue seen in the base of tongue caused due to aberrant embryological development. It is often asymptomatic but...
Lingual thyroid is an abnormal mass of ectopic thyroid tissue seen in the base of tongue caused due to aberrant embryological development. It is often asymptomatic but may cause local symptoms, such as dysphagia, dysphonia, and upper airway obstruction. In this case, we report a 13-year-old girl who presented with dysphagia and breathing difficulty. Local examination revealed thyroid tissue in the posterior aspect of the tongue. Thyroid scintigraphy showed abnormal tracer uptake at base of tongue. Hormonal test showed subclinical hypothyroidism. She was treated with Levothyroxine.
PubMed: 31041293
DOI: 10.4103/jfmpc.jfmpc_2_19 -
Case Reports in Endocrinology 2021Thyroid tissue presenting as a nodule in the base of the tongue due to the embryonic failure to descend to the anterior neck is a rare clinical entity, called lingual...
Thyroid tissue presenting as a nodule in the base of the tongue due to the embryonic failure to descend to the anterior neck is a rare clinical entity, called lingual thyroid. Clinical presentation varies depending upon the degree of obstruction caused by an enlarged nodule or features related to thyroid function. We report a case of a 27-year-old female who presented with a foreign body sensation in the throat with mild dysphagia for 3 weeks. The patient was diagnosed as lingual thyroid with subclinical hypothyroidism based on clinical findings, imaging, and fine-needle aspiration cytology. Conservative management with hormone suppression can result in size reduction of ectopic thyroid tissue improving symptoms without surgery. Lingual thyroid with mild symptoms and subclinical hypothyroidism can be managed conservatively.
PubMed: 33564479
DOI: 10.1155/2021/6693477