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

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.

Author(s):  
Rachna Dhingra ◽  
Gurbax Singh ◽  
Kuldeep Kumar ◽  
Vignesh A. K. ◽  
Pavail Singh ◽  
...  

<p class="abstract">Lingual thyroid is defined as an ectopic thyroid gland tissue located in the midline of the tongue base. Patients with lingual thyroid tissue usually present with symptoms such as dysphagia, choking, haemorrhage, dyspnea and occasionally life threatening airway obstruction. Lingual thyroid is a rare anomaly with an incidence of 1 in 3000 of the thyroid cases seen, with overall prevalence of 1 in 100,000. Here we presented a case with complaint of difficulty in swallowing and foreign body sensation throat. The intraoral examination showed spherical mass with 2 cm of diameter, covered with intact mucosa, located midline at base of tongue. She was diagnosed clinically as lingual thyroid and evaluated further. By proper transdisciplinary approach correct diagnosis can be made and patient can be managed. In present case, thyroid profile, USG neck and thyroid scintigraphy helped in diagnosis. Patient was managed medically with tablet levothyroxine which relieved her symptoms. Surgical management was not considered as patient improved with levothyroxine and surgical excision would have made patient further hypothyroid as there was no thyroid gland in neck.</p>


1996 ◽  
Vol 105 (4) ◽  
pp. 312-316 ◽  
Author(s):  
James D. Williams ◽  
Oleh Slupchinskij ◽  
Anthony P. Sclafani ◽  
Claude Douge

Lingual thyroid gland is a rare clinical entity that is due to failure of descent of the gland anlage early in the course of embryogenesis. It may present with symptoms of dysphagia, upper airway obstruction, or even hemorrhage at any time from infancy through adulthood. We present two illustrative cases of lingual thyroid gland along with a protocol for diagnosis and management of the condition. Elements in the diagnostic and therapeutic evaluation are described with attention to the clinical findings, laboratory tests, and radiographic imaging studies employed in confirming the diagnosis and planning appropriate treatment The natural history of the condition is reviewed and a treatment strategy is outlined that focuses on the use of suppressive doses of thyroid hormone as the initial therapy. Surgical excision of the gland is reserved for more advanced cases of gland enlargement resulting in airway compromise, severe dysphagia that limits oral intake, or ongoing hemorrhage.


2012 ◽  
Vol 126 (12) ◽  
pp. 1287-1291 ◽  
Author(s):  
Tingwei Bao ◽  
Huiming Wang ◽  
Dong Wei ◽  
Di Yu

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.


2016 ◽  
Vol 8 (3) ◽  
pp. 122-124
Author(s):  
Ravinder Kumar ◽  
Abhishek Bhargava ◽  
Gagan Jaiswal

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.


2019 ◽  
Vol 6 (7) ◽  
pp. 2514
Author(s):  
Anantha Kumar Nateson ◽  
Suresh Nayak Basavanayak ◽  
Sudarsansrikanth .

Background: Lichtenstein’s hernioplasty is the commonly done surgery for inguinal hernias. The present study is aimed to study the Lichtenstein’s hernioplasty and its postoperative complications for different types of inguinal hernia.Methods: This prospective study was conducted at Department of General Surgery, MVJ Medical College and Research Hospital, Hoskote, Bangalore Rural, Karnataka. A total of 90 patients were selected for this study. Subjects with the age of 21 to 75 years with inguinal hernia are included in the study. A pre-designed proforma was used to collect their details. All selected cases were studied up to discharge regarding the type of hernia and followed up in OPD for 1 year regarding post-operative complications.Results: Immediate post-op complications like seroma/hematoma was observed in 10 (11.1%), wound infection was in 5 (5.5%) and orchitis was in 2 (2.2%). Post-operative complications like stiffness in lower abdomen was observed in 21 (23.3%) patients. Long term complications like forein body sensation was experienced by 22 (24.4) patients post-operatively at 1 month follow up, 8 (8.8%) patients at 3 months follow up and 3 (3.3) patients at 1 year follow up.  Chronic pain was experienced by 17 (18.8%) patients at the end of 1 month follow up, at 3 month follow up, 13 (14.4%) patients and at the end of 1 year of follow up 4 (4.4%) patients at operated site. Recurrence was not observed in any of the patient.Conclusions: The study findings indicate that Lichtenstein’s hernioplasty was safe and reliable procedure for inguinal hernia repair. 


2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Khaled Khamassi ◽  
Habib Jaafoura ◽  
Fahmi Masmoudi ◽  
Rim Lahiani ◽  
Lobna Bougacha ◽  
...  

Ectopy of the thyroid gland is an abnormal embryological development. Its occurrence in children is rare. In this study, we report the case of a 12-year-old girl that presented with dysphagia and nocturnal dyspnea. Magnetic resonance imaging confirmed the presence of a lingual thyroid. Thyroid scintigraphy showed intense and elective uptake of radiotracer at the base of the tongue. Hormonal tests revealed hypothyroidism. Treatment consisted of opotherapy based on levothyroxine. Evolution has been favourable and the patient showed significant improvement with reduction of the dyspnea and the dysphagia and normalization of thyroid hormone tests.


2004 ◽  
Vol 122 (2) ◽  
pp. 67-69 ◽  
Author(s):  
Alfio José Tincani ◽  
Antonio Santos Martins ◽  
André Del Negro ◽  
Priscila Pereira Costa Araújo ◽  
Gilson Barretto

CONTEXT: Lingual thyroid gland is a rare clinical entity that is caused by the failure of the thyroid gland to descend to a normal cervical location during embryogenesis. The occurrence of an ectopic thyroid gland located at the base of the tongue may cause problems for the patient, with symptoms of dysphagia, dysphonia, upper airway obstruction or even hemorrhage at any time from infancy through adulthood. CASE REPORT: We report on a case of lingual thyroid gland in a 41-year-old female patient. The embryology and diagnosis of ectopic thyroid are discussed and its management is outlined. Features of the diagnostic and therapeutic evaluation are described with attention to the clinical findings, laboratory tests, thyroid scan and computed tomography imaging studies employed in the confirmation of diagnosis and planning of appropriate treatment. The history of the condition is reviewed and a treatment strategy is outlined. Surgical excision of the gland is reserved for cases of gland enlargement that result in compromised airways (dysphagia or dysphonia) or recurrent hemorrhage.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Pakaworn Vorasart ◽  
Chutintorn Sriphrapradang

Abstract Introduction: The diagnosis of subacute painful thyroiditis (SAT) is primarily based on clinical manifestations (thyroid tenderness and diffuse goiter). Suppressed TSH, elevated erythrocyte sedimentation rate (ESR) and low thyroid uptake help confirm the diagnosis. Thyroid ultrasonography and fine-needle aspiration biopsy (FNAB) are rarely necessitated. SAT produces a typical sonographic findings of ill-defined heterogeneously hypoechoic areas, which is difficult to differentiate from thyroid carcinoma. We herein report a patient with SAT who was initially diagnosed as malignancy. Case Presentation: A 36-year-old female had pain and swelling at the left thyroid gland for 3 weeks. A left thyroid nodule was diagnosed by her primary care physician. Ultrasonography revealed a poorly defined hypoechoic nodule measuring 2.5x1.1x1.5 cm at the mid pole of the left thyroid gland, for which biopsy was recommended. The nodule showed peripheral vascularity and no calcification. No suspicious cervical lymphadenopathy was detected. Histologic analysis from core biopsy found findings consistency with follicular neoplasm. Thyroid function tests were within normal range. She was treated with ibuprofen as management of thyroid pain and referred for surgery. However, the repeated ultrasonography was performed by endocrinologist in the next 2 weeks and found an interval reduction in size of hypoechoic lesion. FNAB was performed due to the risk of infiltrative malignancies. Cytologic analysis was compatible with SAT. ESR was slightly elevated. Surgery was cancelled and she was treated with ibuprofen. Two weeks later, she reported that the left thyroid pain and swelling had subsided. However, she developed thyroid pain associated with glandular tenderness and swelling of the right thyroid. On sonographic examination, the right lobe, which was previously normal was now similarly affected. Thyroid function showed thyrotoxicosis. The patient was given a further course of beta-blocker, ibuprofen and prednisolone for 2 weeks and recovered well. On follow-up at 2 months, the patient developed biochemical hypothyroidism and received levothyroxine replacement. The lesions in the thyroid gland were not visualized in the 6-month follow-up sonography. Conclusion: The ultrasonographic features of the thyroid during the acute stage of SAT may mimic thyroid carcinoma. Awareness of the sonographic findings and interval changes of SAT lesions may helpful for proper diagnosis and treatment of SAT.


1970 ◽  
Vol 10 (3) ◽  
pp. 216-219
Author(s):  
AR Roslenda ◽  
H Salina ◽  
KN Gopalan ◽  
SHA Primuharsa Putra

Background: Lingual thyroid is a rare clinical entity that represents faulty migration of normal thyroid gland. It commonly presents as a benign mass found at the junction of the anterior two-thirds and posterior one-third of the tongue. Although usually asymptomatic, glandular hypertrophy can cause dysphonia, dysphagia, bleeding, or stridor at any time from infancy through adulthood. We report a case that we encountered, discuss the diagnosis and its management, and review the literature. An otherwise asymptomatic 14 year-old girl presented with a posterior tongue mass that had been present since childhood but was never investigated. She was clinically and biochemically euthyroid, with normal thyroid function tests. Physical examination revealed a smooth, globular mass occupying the whole tongue base and valleculae. The epiglottis was slightly displaced posteriorly but the laryngeal inlet was patent. A 99mTcradioisotope scan showed accumulation of tracer in the tongue base and no uptake in the neck. MRI revealed a 1.8-cm diameter soft tissue mass in the posterior part of the tongue. To date she has not required suppressive therapy or surgical intervention. Conclusions: Treatment of lingual thyroid depends on patient symptoms. Most importantly, patients should be followed at regular intervals and educated on the possibility of developing complications. Key words: Lingual thyroid, ectopic thyroid, thyroid gland. DOI: http://dx.doi.org/10.3329/bjms.v10i3.8370 BJMS 2011; 10(3): 216-219


2007 ◽  
Vol 135 (3-4) ◽  
pp. 201-203 ◽  
Author(s):  
Djordje Marina ◽  
Silvija Sajic

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. .


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