Transposition of a lingual thyroid to the submandibular space using a modified technique

2012 ◽  
Vol 126 (12) ◽  
pp. 1287-1291 ◽  
Author(s):  
Tingwei Bao ◽  
Huiming Wang ◽  
Dong Wei ◽  
Di Yu
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Thyroid Tissue ◽  
Treatment Method ◽  
Vascular Supply ◽  
Lingual Thyroid ◽  
Modified Technique ◽  
Submandibular Region ◽  
Submandibular Space

AbstractObjective:We report a modified surgical technique for transplanting an ectopic, lingual thyroid to the submandibular space, in order to maintain thyroid function while relieving obstructive symptoms.Case report:A 52-year-old woman complained of progressive dysphagia and dyspnoea. Ectopic lingual thyroid tissue was diagnosed. The ectopic thyroid gland was transplanted into the submandibular region via a lateral pharyngeal approach. A random muscle pedicle was prepared to provide a vascular supply to the transposed gland.Results:Twelve-month follow up confirmed the survival of the transplanted thyroid gland, with preserved thyroid function.Conclusion:Surgical transplantation of a lingual thyroid to the submandibular region offers an alternative treatment method for this anomaly, which avoids the need for resection and lifelong thyroxine replacement.

scholarly journals Ectopic thyroid masquerading as submandibular tumour: a case report

2011 ◽  
Vol 93 (6) ◽  
pp. e77-e80 ◽  
Author(s):  
AD Deshmukh ◽  
R Katna ◽  
A Patil ◽  
DA Chaukar ◽  
S Basu ◽  
...  
Keyword(s):  
Case Report ◽  
Thyroid Gland ◽  
Thyroid Tissue ◽  
Ectopic Thyroid ◽  
Lingual Thyroid ◽  
Review Of The Literature ◽  
Submandibular Region ◽  
Submandibular Space ◽  
Ectopic Thyroid Tissue ◽  
Cervical Cysts

An ectopic thyroid gland may be present in any location along the path of migration from the foramen caecum to the mediastinum. The most common locations for an ectopic thyroid are the lingual thyroid followed by median cervical cysts. An ectopic thyroid in the submandibular region is extremely rare. We present the case of a 44-year-old patient with ectopic thyroid tissue in submandibular space and a review of the literature related to it.

scholarly journals Submandibular ectopic thyroid gland: an uncommon presentation

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Inès Riahi ◽  
Rim Fradi ◽  
Ibtissem Ben Nacef ◽  
Ahlem Blel
Keyword(s):  
Thyroid Gland ◽  
Thyroid Tissue ◽  
Ectopic Thyroid ◽  
Lingual Thyroid ◽  
Submandibular Region ◽  
Case Presentation ◽  
Thyroglossal Duct ◽  
Common Presentation ◽  
Ectopic Thyroid Tissue ◽  
Uncommon Presentation

Abstract Background Ectopic thyroid is a developmental anomaly of the thyroid gland of embryological origin. Instead of having a pretracheal situation, thyroid tissue is elsewhere, most commonly in the median cervical line along the course of the thyroglossal duct. Lingual thyroid is the most common presentation. Ectopic thyroid tissue in the submandibular region has been rarely reported. Case presentation We report herein a case of a 65-year-old man admitted to our department with a complaint of a painless swelling in the left submandibular region. Conclusions Thyroid gland ectopia should be considered among the differential diagnoses of submandibular swelling. Ectopic thyroid tissue can present with the same pathology affecting the normal thyroid gland such as malignancy and hyperthyroidism.

Lingual Thyroid

1977 ◽  
Vol 86 (6) ◽  
pp. 841-848 ◽  
Author(s):  
Dudley J. Weider ◽  
Willard Parker
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Thyroid Tissue ◽  
Surgical Removal ◽  
Lingual Thyroid ◽  
Diagnostic Measures ◽  
Pathologic Findings

The literature on lingual thyroid is reviewed. The incidence is relatively rare and sex incidence is four or five to one in favor of females. The embryology and development of the thyroid gland is discussed and some evidence presented to suggest that the lateral thyroid primordia are not involved in the formation of functional thyroid tissue. The pathologic findings of lingual thyroid tissue are similar to that of cervical thyroid tissue, including goiter formation. Diagnostic measures include mirror examination, I-125 scan, and tomography. Thyroid function studies are helpful in evaluating the level of thyroid function. Treatment includes surgical removal, transplantation, I-131, and thyroid replacement. Since the first three methods usually require supplemental thyroid treatment afterward, it is believed that initial thyroid replacement is the treatment of choice since it is simple, safe, effective, and noninvasive. Four new cases are reported.

scholarly journals An unusual case of struma ovarii

2021 ◽  
Vol 2021 ◽  
Author(s):  
Viktoria F Koehler ◽  
Patrick Keller ◽  
Elisa Waldmann ◽  
Nathalie Schwenk ◽  
Carolin Kitzberger ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Adnexal Mass ◽  
Thyroid Tissue ◽  
Reference Interval ◽  
Struma Ovarii ◽  
Radioiodine Uptake ◽  
Diagnostic Pitfalls ◽  
Biochemical Features

Introduction Struma ovarii is a teratoma of the ovaries predominantly composed of thyroid tissue. Hyperthyroidism associated with struma ovarii is rare, occurring in approximately 8% of cases. Due to the rarity of struma ovarii, available data are limited to case reports and small case series. Methods and results We report on a 61-year-old female patient with known Hashimoto’s thyroiditis on levothyroxine replacement therapy for years with transition to clinical and biochemical hyperthyroidism despite antithyroid medication with carbimazole (10 mg/day), new diagnosis of urothelial carcinoma and an adnexal mass suspicious of ovarian cancer. The patient underwent resection of the adnexal mass and histopathology revealed a mature teratoma predominantly composed of thyroid tissue showing high levels of sodium iodide symporter protein expression. Following struma ovarii resection and disappearance of autonomous production of thyroid hormones, the patient developed hypothyroidism with severely decreased thyroid hormone levels fT4 and fT3 (fT4 0.4 ng/dL, reference interval 0.9–1.7 and fT3 < 1.0 pg/mL, reference interval 2.0–4.4). This has previously been masked by continued thyroid-stimulating hormone suppression due to long-term hyperthyroidism pre-surgery indicating secondary hypothyroidism, in addition to primary hypothyroidism based on the known co-existing chronic lymphocytic thyroiditis of the orthotopic thyroid gland. Levothyroxine administration was started immediately restoring euthyroidism. Conclusion This case illustrates possible diagnostic pitfalls in a patient with two concurrent causes of abnormal thyroid function. Learning points Struma ovarii is an ovarian tumor containing either entirely or predominantly thyroid tissue and accounts for approximately 5% of all ovarian teratomas. In rare cases, both benign and malignant struma ovarii can secrete thyroid hormones, causing clinical and biochemical features of hyperthyroidism. Biochemical features of patients with struma ovarii and hyperthyroidism are similar to those of patients with primary hyperthyroidism. In such cases, thyroid scintigraphy should reveal low or absent radioiodine uptake in the thyroid gland, but the presence of radioiodine uptake in the pelvis in a whole body radioiodine scintigraphy. We give advice on possible diagnostic pitfalls in a case with two simultaneous causes of abnormal thyroid function due to the co-existence of struma ovarii.

The Thyroid

2011 ◽  
Author(s):  
Ildiko Lingvay ◽  
Shelby A. Holt
Keyword(s):  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Classical Model ◽  
Critical Role ◽  
Thyroid Tissue ◽  
Endocrine Organ ◽  
Thyroglossal Duct ◽  
Parafollicular Cells ◽  
Developing Heart

The thyroid gland, which is the largest endocrine organ, secretes primarily thyroid hormones that play a critical role in the normal growth and development of the maturing human. In the adult, thyroid hormones maintain metabolic stability by regulating oxygen requirements, body weight, and intermediary metabolism. Thyroid function is under hypothalamic-pituitary control, and thus, like the gonads and adrenal cortex, it serves as a classical model of endocrine physiology. In addition, the physiological effects of thyroid hormones are regulated by complex extrathyroidal mechanisms resulting from the peripheral metabolism of the hormones, mechanisms that are not under hypothalamic-pituitary regulation. Thyroid function abnormalities are very prevalent, especially in females and in certain geographic areas, and are often a result of autoimmunity or iodine deficiency. The thyroid originates from two distinct parts of the embryonic endoderm: • The follicular structures arise from a midline thickening of the anterior pharyngeal floor (the base of the tongue), adjacent to the differentiating heart. This thyroid diverticulum first expands ventrally while still attached to the pharyngeal floor by its stalk (thyroglossal duct), and then expands laterally, leading to the characteristic bilobed structure. As the developing heart descends, the thyroid gets pulled into its final position, a process that leads to the rapid stretch and degeneration of the thyroglossal duct. • The parafollicular cells are derived from the ultimobranchial bodies (originating from the neural crest) but ultimately are surrounded by the medial thyroid. The parafollicular cells represents <10 % of the adult thyroid gland. The thyroid completes its structural development by 9 weeks of gestation, the first endocrine organ to assume its definitive form during organogenesis; yet full functional maturation and integration with the hypothalamic-pituitary axis continues throughout gestation. Abnormal thyroid development can lead to persistence of the thyroglossal duct, presence of ectopic thyroid tissue (lingual thyroid, lateral aberrant thyroid), and malposition (thoracic goiter), all of which can remain clinically silent or present later in life as diagnostic challenges. The shape of the human thyroid resembles that of a butterfly.

Simultaneous occurrence of a thyroglossal duct cyst and a lingual thyroid in the absence of an orthotopic thyroid gland

2011 ◽  
Vol 126 (2) ◽  
pp. 217-220 ◽  
Author(s):  
J Madana ◽  
R Kalaiarasi ◽  
D Yolmo ◽  
S Gopalakrishnan
Keyword(s):  
Thyroid Gland ◽  
English Language ◽  
Thyroid Tissue ◽  
Clinical Findings ◽  
Thyroglossal Duct Cyst ◽  
Simultaneous Occurrence ◽  
Lingual Thyroid ◽  
Duct Cyst ◽  
Thyroglossal Duct ◽  
Thyroglossal Duct Cysts

AbstractObjective:We report an extremely rare case of the simultaneous occurrence of a thyroglossal duct cyst and a lingual thyroid in the absence of an orthotopic thyroid gland, in a seven-year-old girl from South India.Method:Case report and a review of the English language literature on the subject.Results:The patient presented with a mass on the tongue that had been present for three years, and an anterior neck swelling that had been present for two years. Examination revealed a midline, pinkish, firm mass present on the posterior one-third of the tongue. The neck showed a midline cystic swelling in the infrahyoid position. Radiological imaging confirmed the clinical findings, revealing the absence of her thyroid gland in the normal location. Sistrunk's procedure was performed leaving behind a lingual thyroid. At 13-month follow up, the patient was euthyroid with no recurrence.Conclusion:To our knowledge the association of a lingual thyroid and a thyroglossal cyst has only been reported once in the literature. The presence of a lingual thyroid in the absence of a normally located thyroid gland or functioning thyroid tissue along the thyroglossal tract, confirmed by radionuclide and computed tomography imaging, may indicate the failure of the normal descent of the thyroid gland during embryonic development. This probable absence of the descent of the thyroid raises questions regarding the origin of thyroglossal duct cysts.

Imaging of the Lingual Thyroid: A Case Report and Management

2016 ◽  
Vol 8 (3) ◽  
pp. 122-124
Author(s):  
Ravinder Kumar ◽  
Abhishek Bhargava ◽  
Gagan Jaiswal
Keyword(s):  
Case Report ◽  
Thyroid Gland ◽  
Thyroid Tissue ◽  
Upper Airway ◽  
Lingual Thyroid ◽  
Developmental Abnormality ◽  
Endoscopic Removal ◽  
Current Case ◽  
Male Ratio ◽  
Imaging Characteristics

ABSTRACT Lingual thyroid is a rare developmental abnormality characterized by the failure of the thyroid gland, or remnants, to descend from anywhere along its embryologic path of origin at the foramen cecum to its normal eutopic pretracheal position. Awareness of the anatomic course of the embryologic thyroid primordium, typical and atypical locations of ectopic thyroid tissue may aid in diagnosis. The reported incidence of lingual thyroid is 1 in 100,000, and it is more common in females, with a female to male ratio ranging between 3:1 and 7:1. Lingual thyroid located at the base of tongue often present with hypothyroidism, usually asymptomatic but may cause dysphonia, dysphagia, upper airway obstruction, and hemorrhage. In the current case report, we present the imaging characteristics of lingual thyroid occurring in a 12-year-old female patient. Partial endoscopic removal of lingual thyroid was performed, followed by substitutive exogenous thyroid hormone therapy. The purpose of this study is to discuss the radiological characteristics and therapeutic issues in the management of lingual thyroid. How to cite this article Kumar R, Bhargava A, Jaiswal G. Imaging of the Lingual Thyroid: A Case Report and Management. Int J Otorhinolaryngol Clin 2016;8(3):122-124.

scholarly journals Thyroid Abscess Initially Presenting as Destructive Thyroiditis With Subsequent Hypothyroidism

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A961-A961
Author(s):  
Ahl Jeffrey Caseja ◽  
Richard L Wang ◽  
Samer Nakhle
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Fluid Collection ◽  
Neck Mass ◽  
Vascular Supply ◽  
Thyroid Function Tests ◽  
Ct Guided ◽  
Hormone Synthesis ◽  
Function Tests ◽  
Thyroid Abscess

Abstract Introduction: Due to its rich vascular supply and high iodine content infection of the thyroid gland is rare and is uncommonly associated with hyperthyroidism. We report a case of a thyroid abscess presenting with hyperthyroidism with subsequent hypothyroidism in an immunocompetent patient. Clinical Case: A 34-year old female with no past medical history presented with an enlarging neck mass associated with worsening, non-radiating throat pain of three-week duration associated with dysphagia. She reports 15-lb weight loss and palpitations. On presentation vital signs were within normal range. Physical examination revealed a diffusely tender anterior neck mass. Her thyroid function tests revealed TSH 0.01 uIU/mL (0.358-3.74), FT4 2.4 ng/dL (0.76-1.46), TSI &lt;0.10 IU/L (0.00-0.55), TPO 12 IU/mL (0-34). Laboratory workup was also significant for leukocytosis, thrombocytosis, and hyponatremia. Thyroid ultrasound revealed a large, irregularly shaped, multiloculated fluid collection involving both lobes measuring 6.4 x 4.8 x 2.0 cm. She was started on Vancomycin and Ampicillin/Sulbactam, Metoprolol, and Methimazole. Needle aspiration of 30 cc of purulent material was performed with culture showing a heavy growth of streptococcus constellatus sensitive to penicillin. After a 4-day inpatient stay, she was discharged with Amoxicillin/Clauvanate as well as Methimazole 10mg BID. Ten days after being discharged, the patient again presented to the emergency department with complaint that the neck mass had increased in size. CT neck showed a 5.1 x 2.8 x 0.8 cm lobulated fluid collection. CT-guided drainage was performed, cytology and wound culture were found to be unremarkable. Thyroid function tests revealed she was hypothyroid with TSH 31.157 uIU/mL and FT4 of 0.72 ng/dL. Upon discharge, Methimazole was discontinued and she was started on Levothyroxine 75 mcg daily. Due to failure of prior antibiotics, she received a 14-day course of IV Ceftriaxone. Outpatient follow-up eight weeks later showed she was euthyroid on Levothyroxine 75 mcg with ultrasound revealing small thyroid gland with resolution of the abscess. Conclusion: Hyperthyroidism in the setting thyroid abscess is secondary to destructive thyroiditis. As there is no increase in thyroid hormone synthesis, there is no role for treatment with antithyroid medication. Symptomatic control with beta-blocker, surgical drainage, and IV antibiotics are recommended for cases of thyroid abscesses. If infection persists or extensive necrosis develops, thyroidectomy may be indicated. Hypothyroidism can be a consequence of destructive thyroiditis as was seen in this patient.

Radioiodine in the Diagnosis and Therapy of Solitary Hyperfunctioning Thyroid Nodules

1968 ◽  
Vol 07 (01) ◽  
pp. 82-90
Author(s):  
A. Y. Al Hindawi ◽  
Th. N. Al-Hiti ◽  
W. I. Baba
Keyword(s):  
Thyroid Gland ◽  
Thyroid Nodule ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Clinical Presentation ◽  
Radioiodine Therapy ◽  
Thyroid Tissue ◽  
Toxic Adenoma ◽  
Diagnosis And Therapy ◽  
High Doses

SummaryThe clinical presentation, the incidence, and the results of radioiodine tests in 80 patients with hyperfunctioning thyroid nodule confirmed by scanning are presented. 52 patients had toxic adenoma and 28 were euthyroid.The value of different radioiodine tests of thyroid function in confirming the diagnosis is discussed.The topographical changes in both hyperfunctioning nodule and suppressed tissue of the thyroid gland following exogenous TSH and radioiodine therapy showed refunctioning of suppressed thyroid tissue.Relatively high doses of radioiodine were required to treat toxic adenoma of the thyroid gland.

scholarly journals Conservative Management for Lingual Thyroid Ectopic

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Eder Alberto Sigua-Rodriguez ◽  
Douglas Rangel Goulart ◽  
Luciana Asprino ◽  
Afonso Celso de Moraes Manzano
Keyword(s):  
Thyroid Gland ◽  
Upper Airway ◽  
Surgical Approaches ◽  
Lingual Thyroid ◽  
Thyroid Function Tests ◽  
Body Sensation ◽  
Different Types ◽  
Spherical Mass ◽  
Base Of The Tongue

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 withTc99mand 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.

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