The hormonal suppression as first-line treatment of lingual thyroid: A case report

Ectopic thyroid gland is a rare anomaly in the development of the thyroid gland. It is defined as any thyroid tissue that is not found on its usual topography. We present the case of a 62-year-old patient with difficulty swallowing solid food, occasional sore throat, hoarse voice, and difficulty speaking. The patient was in hypothyroid status. Thyroid scintigraphy and magnetic resonance imaging visualized a nodular mass on the base of the tongue, suprahyoid, and mediosagittal. The pathohistological finding revealed normal thyroid tissue with few colloidal changes, ruled out tumour infiltration and specific inflammatory process. She received hormonal suppression treatment as a first-line treatment. The patient showed significant improvement in symptoms with reduction of the dyspnea and the dysphagia and normalization of thyroid hormone tests.

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Alemtuzumab Induced Thyroid Disease in Multiple Sclerosis: A Review and Approach to Management

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2015.48 ◽

2015 ◽

Vol 42 (5) ◽

pp. 284-291 ◽

Cited By ~ 11

Author(s):

Moeber Mahzari ◽

Amel Arnaout ◽

Mark S. Freedman

Keyword(s):

Multiple Sclerosis ◽

Monoclonal Antibody ◽

Autoimmune Disease ◽

Thyroid Gland ◽

Thyroid Disease ◽

Thyroid Dysfunction ◽

Simple Approach ◽

Line Treatment ◽

First Line ◽

First Line Treatment

AbstractAlemtuzumab, an anti-CD52 monoclonal antibody, was recently approved for treatment of MS in Canada, having shown to significantly reduce relapses and disability in patients, particularly those who relapsed despite first line treatment. Offsetting its benefit however, is the development of novel secondary autoimmune disease, particularly affecting the thyroid gland in up to 36% of patients. The incidence of Alemtuzumab induced thyroid dysfunction (AITD) will likely rise as alemtuzumab becomes more widely used for treating MS. We review the clinical and investigational cues that help delineate the aetiology and management of thyrotoxicosis and hypothyroidism in ATID. AITD can be easily managed and we present a simple approach for its evaluation and management by neurologists that should be implemented prior to considering a referral to an internist or endocrinologist for further opinion or treatment.

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Ectopic Lingual Thyroid

Case Reports in Pediatrics ◽

10.1155/2015/252357 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Khaled Khamassi ◽

Habib Jaafoura ◽

Fahmi Masmoudi ◽

Rim Lahiani ◽

Lobna Bougacha ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Thyroid Hormone ◽

Magnetic Resonance ◽

Thyroid Gland ◽

Lingual Thyroid ◽

Embryological Development ◽

Thyroid Scintigraphy ◽

Resonance Imaging ◽

Base Of The Tongue

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.

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Lingual thyroid

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0704201m ◽

2007 ◽

Vol 135 (3-4) ◽

pp. 201-203 ◽

Cited By ~ 4

Author(s):

Djordje Marina ◽

Silvija Sajic

Keyword(s):

Thyroid Gland ◽

Thyroid Tissue ◽

Ectopic Thyroid ◽

Suppressive Therapy ◽

Lingual Thyroid ◽

Thyroid Status ◽

Hormone Substitution ◽

Female Population ◽

Age Related ◽

Base Of The Tongue

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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