Evaluation and Management of the Lingual Thyroid Gland

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.

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 14 (2) ◽  
pp. 107-109
Author(s):  
Md Shahriar Islam ◽  
Lipika Sanjowal ◽  
SM Abdul Awual ◽  
Mohd Rafiul Alam ◽  
Md Rafiqul Islam ◽  
...  

Ectopic thyroid tissue can be found anywhere between the foramen cecum and the normal position of the thyroidgland. Although very uncommon, it is most often found in the region of the foramen cecum, in patients in whom thegland fails to descend. It may present with symptoms of dysphagia, upper airway obstruction, or even hemorrhage atany time from infancy through adulthood. We present the case of a twelve-year-old male child with a midline cervicalmass clinically presented with high dysphagia suffering for one year. Dysphagia worsened over the past two monthsand was accompanied by increasing in nocturnal dyspnoea and recent onset of sleep apnea. Elements in the diagnosticand therapeutic evaluation are described with attention to the clinical findings, laboratory tests, and radiographicimaging studies employed in confirming the diagnosis and planning appropriate treatment. The natural history of thecondition is reviewed and a treatment strategy is outlined that focuses on the use of suppressive doses of thyroidhormone as the initial therapy. Surgical excision of the gland is reserved for more advanced cases of glandenlargement resulting in airway compromise, severe dysphagia that limits oral intake, or ongoing hemorrhage. Faridpur Med. Coll. J. Jul 2019;14(2): 107-109


2016 ◽  
Vol 22 (3) ◽  
pp. 203-207
Author(s):  
R. Osman ◽  
V. Sarbu ◽  
S. Osman

Abstract Introduction: The aim of this paper is to present a case of rare retroperitoneal tumor. Material and Methods. A 72 year old man presented with six month history of abdominal girth, lumbar pain and occasional episodes of constipation was admitted in our clinic. A computed tomographic abdominal scan revealed a retroperitoneal solid mass. Surgical exploration performed later displayed solid and well delimited mass throughout retroperitoneal space followed by excision of lesion and multiple drainages. Microscopic pathological examination was benign nerve sheath tumor. Conclusion. These tumors are characteristically firm, smooth, and asymptomatic. They range in size from 1-2 mm to over 20 cm. Awareness of this indolent and rare condition is an important prerequisite for early diagnosis and appropriate treatment. Surgical excision can usually be accomplished by enucleating of the tumor without damage to the adjacent nerve.


2019 ◽  
Vol 5 (2) ◽  
pp. 205511691986717
Author(s):  
Maureen E Thieme ◽  
Anastasia M Olsen ◽  
Andrew D Woolcock ◽  
Margaret A Miller ◽  
Micha C Simons

Case summary A 4-year-old neutered male cat was presented with a 2-month history of intermittent constipation that progressed to obstipation. Primary clinical findings included a large, multi lobulated mass in the caudodorsal abdomen, peripheral eosinophilia and hyperglobulinemia. Abdominal imaging revealed a multilobulated, cavitated mass in the sublumbar region. Exploratory celiotomy revealed multiple firm masses in the sublumbar retroperitoneal space causing ventral displacement and compression of the descending colon with extension of the masses into the pelvic canal. Histopathology was consistent with feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF). Aerobic culture was positive for Staphylococcus aureus. The cat was treated with prednisolone (2 mg/kg PO q24h), lactulose (0.5 g/kg PO q8h), amoxicillin/clavulanic acid (62.5 mg/cat PO q12h for 1 month) and fenbendazole (50 mg/kg PO q24h for 5 days). Six months postoperatively, the cat had no recurrence of clinical signs. Repeat evaluation and imaging at day 732 postoperatively revealed marked improvement of the abdominal mass, resolution of peripheral eosinophilia and no clinical signs with continued prednisolone therapy (0.5 mg/kg PO q24h). Relevance and novel information This is a report of a primary extramural FGESF lesion, and the first description of characteristics of FGESF on CT. Previous evidence suggests that the most favorable outcomes require immunosuppressive therapy and complete surgical excision; however, this case demonstrates a favorable outcome with medical management alone.


2011 ◽  
Vol 126 (2) ◽  
pp. 217-220 ◽  
Author(s):  
J Madana ◽  
R Kalaiarasi ◽  
D Yolmo ◽  
S Gopalakrishnan

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.


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.


2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Sk. Abdul Mahmud ◽  
Neha Shah ◽  
Moumita Chattaraj ◽  
Swagata Gayen

Neurofibromas are benign tumors of nerve cell origin arising due to proliferation of Schwann cells and fibroblasts. They are usually asymptomatic and hence remain undiagnosed. They are commonly found on the skin and intraorally tongue is the most common site for their occurrence. Here, we present a unique case of solitary encapsulated neurofibroma in the oral cavity without any clinical manifestations or family history of Neurofibromatosis type 1 in a 73-year-old female patient who presented with a painless swelling on the tongue. The histopathologic findings closely mimicked benign fibrous histiocytoma. In our case, definitive diagnosis of neurofibroma was made based on clinical findings, family history, and histopathological and immunohistochemical evaluation. Through this case report we want to emphasize the role of biopsy and immunohistochemistry in arriving at a confirmatory diagnosis. The patient was treated by surgical excision and showed no signs of recurrence over a follow-up period of 12 months.


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.


2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Iram Khan ◽  
Shweta Gogia ◽  
Alok Agarwal ◽  
Ajay Swaroop

Recurrent rhinosporidiosis is a chronic granulomatous disease with a known tendency to reoccur. Coblation EVAC 70 is a novel surgical tool which seems to provide excellent option in management of this notorious disease. We present an interesting case and the innovative approach in its management, using Coblation system.Introduction. Rhinosporidiosis seeberi causes a chronic granulomatous disease of upper airway, usually involving the nose and nasopharynx, and has a notorious tendency to reoccur. The current line of management is surgical excision of the lesion along with cauterization of the base, which does not prevent reoccurrence of the disease.Case Presentation. A 65-year-old male resident of rural India reported a history of breathing difficulty and change in voice. Patient is a Hindu priest by profession, who according to their rituals has to take bath in local pond or river.Conclusion. Rhinosporidiosis is a difficult to treat pathology due to its tendency to reoccur. Till date the management of the disease is far from satisfactory. Coblation system which has already found its roots in otorhinolaryngology can be used as a novel tool in surgical resection of recurrent rhinosporidiosis and has added advantage of low temperature dissection along with clear surgical field due to constant suctioning.


Author(s):  
Denisse A. Herrera B. ◽  
Joselin Flores V. ◽  
Francisco J. Tejeda N. ◽  
Victor Fierro S. ◽  
Amaury J. Pozos G. ◽  
...  

Focal fibrous hyperplasia (FFH) is an oral mucosal localized non-neoplastic enlargement representing a reaction to chronic local irritations or injuries. The purpose of this report is to describe the management of an asymptomatic fibrotic lesion located in the tongue, in a preschooler boy. A 7-year-6-month old boy attended our clinic for the evaluation of an exophytic pedunculated tumor-like round mass located in the dorsal surface of the tongue. Based on the initial examination and the natural history of the lesion, the presumptive clinical diagnosis determined an irritation FFH. The lesion was surgically excised with a diode laser device, and the postoperative period evolution occurred without any complication. The appropriate treatment of FFH in children initially consists of the removal of local irritant factors. Excellent oral hygiene maintenance and close follow-up care are strongly suggested. Surgical excision is the most frequent modality for persistent lesions. Early diagnosis and proper management of FFH can reduce the risk of future recurrences or complications.


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