Thyroid hemiagenesis with a TI-RADS 2 nodule in the contralateral lobe

Abstract Background Thyroid hemiagenesis is a rare congenital anomaly in which one lobe of the thyroid gland fails to develop. There is an increased incidence of associated thyroid disorders in patients with thyroid hemiagenesis. Case presentation A 32-year-old Ugandan woman presented with a complaint of painless neck swelling of 3-months duration. The swelling was associated with a globus sensation. There was no history of thyroid – related problems or treatment prior to this presentation. Physical examination demonstrated a mobile right thyroid swelling without an obvious nodular contour. Neck ultrasound showed an absent left lobe of thyroid gland, a right lobe with a solitary nodule scoring two points on the Thyroid Imaging, Reporting and Data System (TI-RADS) and an isthmus in situ. Extensive search for possible ectopic thyroid tissue was negative. She was biochemically euthyroid. The patient was counseled about thyroid hemiagenesis and was put on a regular follow up in the clinic for the TI-RADS 2 nodule. Conclusion Thyroid hemiagenesis is often associated with other thyroid disorders. Its diagnosis should prompt an active search for other associated morphological or functional thyroid abnormalities.

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Thyroid Hemiagenesis With TI-RADS 2 Nodule in the Contralateral Lobe: a Case Report

10.21203/rs.3.rs-186435/v1 ◽

2021 ◽

Author(s):

Senai Goitom Sereke ◽

Anthony Oriekot ◽

Felix Bongomin

Keyword(s):

Thyroid Gland ◽

Thyroid Tissue ◽

Thyroid Function Test ◽

Left Lobe ◽

Case Presentation ◽

Hormonal Function ◽

Thyroid Hemiagenesis ◽

History Of

Abstract Background: Thyroid hemiagenesis is a rare congenital anomaly in which one lobe of thyroid gland fails to develop. There is a higher incidence of associated thyroid disorders in patients with thyroid hemiagenesis. Case presentation: A 32-year-old female presented to a hospital with complaint of painless neck swelling of 3-month duration with associated globus sensations. There were no history of thyroid related problems or thyroid related treatment prior to her presentation. Physical examination demonstrated a mobile right thyroid swelling but no obvious nodular contour. Neck ultrasound demonstrated absent left lobe of thyroid gland, right thyroid gland with solitary nodule of TI-RADS 2 and isthmus in situ. Extensive search for possible ectopic thyroid tissue was negative. Thyroid function test was euthyroid. Conclusion: Early detection of this entity and follow up monitoring of thyroid morphologic and hormonal function have paramount importance.

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Ultrasonographic and Scintigraphic Findings of Thyroid Hemiagenesis in a Child: Report of a Rare Male Case

Case Reports in Radiology ◽

10.1155/2015/917504 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3

Author(s):

Ümit Yaşar Ayaz ◽

Sevin Ayaz ◽

Mehmet Ercüment Döğen ◽

Arman Api

Keyword(s):

Thyroid Gland ◽

Thyroid Tissue ◽

Invasive Procedure ◽

Final Diagnosis ◽

Left Lobe ◽

Current Status ◽

Complementary Method ◽

Thyroid Hemiagenesis ◽

Right Lobe ◽

The Right

Thyroid hemiagenesis is a rare congenital anomaly in which one lobe of thyroid gland fails to develop. It is much rarer in males. There is a higher incidence of associated thyroid disorders in patients with thyroid hemiagenesis; therefore early and prompt diagnosis is important for children. We present the ultrasonographic and scintigraphic findings of thyroid hemiagenesis in an eight-year-old-boy. On ultrasonography (US), left lobe of the thyroid gland could not be demonstrated and the right lobe showed minimal hyperplasia. Its echogenicity was normal and no nodule was seen. On thyroid scintigraphy, left lobe of thyroid gland or any ectopic thyroid tissue could not be demonstrated, while the right lobe showed minimal hyperplasia. Without performing any invasive procedure, we enrolled the child in a follow-up program with the guidance of US and scintigraphy, which were effective both in making the final diagnosis of thyroid hemiagenesis and in evaluating the current status of the present thyroid tissue. In conclusion, if only one thyroid lobe is detected in a pediatric case initially with US or scintigraphy, the diagnosis of thyroid hemiagenesis should be suggested and, before any unnecessary or invasive attempt, the other complementary method (scintigraphy/US) should be performed.

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Thyroid Carcinoma on the Side of the Absent Lobe in a Patient with Thyroid Hemiagenesis

Case Reports in Otolaryngology ◽

10.1155/2017/4592783 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Hiroki Sato ◽

Kiyoaki Tsukahara ◽

Ray Motohashi ◽

Midori Wakiya ◽

Hiromi Serizawa ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Papillary Carcinoma ◽

Thyroid Tissue ◽

Needle Aspiration ◽

Left Lobe ◽

Thyroid Hemiagenesis ◽

Poorly Differentiated ◽

Node Metastases ◽

Right Lobe ◽

The Right

Background. Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe. Methods and Results. We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma. Conclusions. All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare.

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Thyroid Hemiagenesis Associated with Hyperthyroidism

Case Reports in Otolaryngology ◽

10.1155/2015/829712 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Gunay Gurleyik ◽

Emin Gurleyik

Keyword(s):

Biochemical Analysis ◽

Thyroid Tissue ◽

Signs And Symptoms ◽

Left Lobe ◽

Total Excision ◽

Total Removal ◽

Nodular Goitre ◽

Thyroid Hemiagenesis ◽

Right Lobe ◽

The Right

Thyroid hemiagenesis (TH), very rare congenital anomaly, is generally asymptomatic. We report two cases of TH with hyperthyroidism.Case One. The patient presented with signs and symptoms of thyrotoxicosis. Physical examination revealed asymmetric nodular goitre at right lobe. Biochemical analysis revealed the diagnosis of hyperthyroidism. Ultrasound showed multinodular hypertrophy in the right lobe and absence of the left lobe. Nuclear scan, confirming absence of the left lobe, showed hot nodules in the right one. The diagnosis was toxic multinodular goitre.Case Two. The thyroid was not palpable in this patient presented with signs and symptoms of thyrotoxicosis. Biochemical analysis revealed the diagnosis of autoimmune thyrotoxicosis. Ultrasound showed mild diffuse hyperplasia of the right lobe and agenesis of the left lobe. Nuclear scan, confirming absence of the left lobe, showed increasing diffuse uptake of radiotracer in the right one. The diagnosis was Graves’ disease in this patient. After antithyroid medication, the patients were surgically treated with total excision of the thyroid tissue. TH is sometimes associated with disorders of the thyroid. Hyperthyroidism makes TH cases symptomatic. During evaluation of patients, ultrasound and nuclear scan usually report agenesis of one lobe and establish the diagnosis of TH. The surgical treatment is total removal of hyperactive tissue and total excision of the remaining lobe.

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Follow-up of a case of subacute thyroiditis with uncommon thyroid 99mTc uptake

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302013000800013 ◽

2013 ◽

Vol 57 (8) ◽

pp. 659-662 ◽

Cited By ~ 1

Author(s):

Zhe Zhang ◽

Chengjiang Li

Keyword(s):

Thyroid Gland ◽

Interstitial Fibrosis ◽

Left Lobe ◽

Subacute Thyroiditis ◽

Short Course ◽

Right Lobe ◽

The Right ◽

Inflammatory Changes ◽

Cellular Destruction

Thyroidal 99mTc uptake in the acute thyrotoxic phase of subacute thyroiditis (SAT) is always inhibited. However, a patient with SAT had signs in the right-side thyroid gland with transient thyrotoxicosis and slightly high 99mTc uptake levels in the right lobe, low 99mTc uptake in the left lobe, and normal overall uptake. Histological examination showed cellular destruction and granulomatous inflammatory changes in the right lobe, with marked interstitial fibrosis in the left lobe. The patient was thyrotrophin-receptor antibody (TRAb) positive. After a short course of prednisolone, SAT-like symptoms and signs improved. TRAb-positivity resolved spontaneously after 22 months, and TSH levels were slightly low for 22 months. Levels then kept normal in the following four years. In conclusion, high 99mTc uptake by the right lobe was due to the combined effects of TRAb and left thyroid gland fibrosis.

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Myoepithelioma-like tumor of the vulvar region: a case report in China and review of the literature

Diagnostic Pathology ◽

10.1186/s13000-019-0923-0 ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 1

Author(s):

Yan Xu ◽

Hui Gao ◽

Jin-Li Gao

Keyword(s):

Tumor Cells ◽

Epithelial Membrane Antigen ◽

S100 Protein ◽

Adult Women ◽

Case Presentation ◽

Mesenchymal Neoplasm ◽

History Of ◽

Subcutaneous Mass

Abstract Background Myoepithelioma-like tumor of the vulvar region (MELTVR) is a recently described mesenchymal neoplasm which typically arising in vulvar regions of adult women. Case presentation Here we report a case of a 65-year-old woman who presented with a 6-year history of subcutaneous mass in the vulvar region. The mass had recently increased in size continuously. Histologically, the tumor cells had an epithelioid to spindled shape. Epithelioid tumor cells proliferated singly or in a loosely cohesive manner with myxoid areas, while spindled tumor cells grew in diffuse sheets or storiform arrangements mainly in nonmyxoid areas. Immunohistochemically, the tumor cells were positive for vimentin, epithelial membrane antigen, calponin, and were partially mild to moderate positive for estrogen receptor, but completely negative for S100 protein, glial fibrillary acidic protein, CD34, desmin, SMA and cytokeratin. INI1/SMARCB1 expression was deficient. EWSR1 and FUS genes were intact tested by fluorescence in situ hybridization analysis. Based on these findings, we diagnose this case as MELTVR. The patient remained relapse-free after the lesion was widely excised during 8 months follow-up. Conclusions This disease should be included in the differential diagnostic list of vulvar tumors with epithelioid to spindled morphology. Recognition of its histopathological features and immunohistochemical reactivity will help to understand the tumor better.

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Congenital thyroid hemiagenesis with multinodular goiter

Acta Radiologica Short Reports ◽

10.1177/2047981614530286 ◽

2014 ◽

Vol 3 (9) ◽

pp. 204798161453028 ◽

Cited By ~ 2

Author(s):

SK Bhartiya ◽

A Verma ◽

S Basu ◽

VK Shukla

Keyword(s):

Thyroid Gland ◽

Histopathological Examination ◽

Nodular Goiter ◽

Cystic Degeneration ◽

Adenomatous Goiter ◽

Thyroid Hemiagenesis ◽

Ct Angiogram ◽

History Of ◽

Right Lobe ◽

The Right

Thyroid hemiagenesis is a rare form of thyroid dysgenesis characterized by an absence of half of the thyroid gland. Developmental hemi-thyroid anomalies can result from either an abnormal descent or an agenesis of one lobe of the thyroid gland. We report a case of a 40-year-old woman with history of a longstanding gradually progressive thyroid swelling without any complication. An ultrasonographic examination diagnosed the absence of the left thyroid lobe and enlargement of the right lobe, which was confirmed on a computed tomography (CT) angiogram and a radionuclide scan of the neck. A cytological examination showed nodular goiter with cystic degeneration. Right subtotal thyroidectomy was performed and histopathological examination confirmed adenomatous goiter with degenerative changes. We report the rarity of the condition and emphasize the role of a comprehensive radiological, cytological, and radionuclide algorithm for an accurate preoperative diagnosis and subsequent management.

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Hemi agenesis of Thyroid Gland in a Euthyroid Child having Positive Family History of Thyroid Disorder

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v17i1.22501 ◽

2015 ◽

Vol 17 (1) ◽

pp. 104-110

Author(s):

Mohammad Simoon Salekin ◽

Fatima Begum ◽

Mohshi Um Mokaddema ◽

Md Sunny Anam Chowdhury ◽

Sadia Sultana ◽

...

Keyword(s):

Family History ◽

Thyroid Gland ◽

Positive Family History ◽

Left Lobe ◽

Developmental Defect ◽

Thyroid Disorder ◽

Thyroid Scan ◽

Hormonal Dysfunction ◽

History Of

Thyroid Hemiagenesis (THA) is a rare form of thyroid developmental anomaly. This developmental defect may or may not coincide with hormonal dysfunction. The detection of anomaly is quite incidental and infrequently found during investigations assessing thyroid functions. A three years old boy presented with gradual swelling in front of neck during last 2 months. He had no history of delayed milestones. Ultrasound imaging and thyroid scan by 99m -Technetium- pertechnetate revealed hemi agenetic development of left lobe of thyroid gland. His biochemical assessment showed euthyroid state. He had positive family history with hypothyroid maternal grandmother and congenital hypothyroid maternal cousin. Ultrasonography and thyroid scan are useful tools for demonstrating this form of dysgenesis of thyroid gland. Follow up monitoring of thyroid function at regular interval in children with congenital anomaly of thyroid gland should be done to take timely measures, if required. DOI: http://dx.doi.org/10.3329/bjnm.v17i1.22501 Bangladesh J. Nuclear Med. 17(1): 104-110, January 2014

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Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

African Journal of Urology ◽

10.1186/s12301-019-0006-1 ◽

2019 ◽

Vol 25 (1) ◽

Author(s):

Danielle Whiting ◽

Ian Rudd ◽

Amit Goel ◽

Seshadri Sriprasad ◽

Sanjeev Madaan

Keyword(s):

Case Reports ◽

Case Presentation ◽

Open Adrenalectomy ◽

Large Size ◽

History Of ◽

Loin Pain ◽

Benign Tumours ◽

Spontaneous Haemorrhage ◽

Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

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Infants Diagnosed with Athyreosis on Scintigraphy May Have a Gland Present on Ultrasound and Have Transient Congenital Hypothyroidism

Hormone Research in Paediatrics ◽

10.1159/000514989 ◽

2021 ◽

pp. 1-8

Author(s):

Niamh McGrath ◽

Colin Patrick Hawkes ◽

Stephanie Ryan ◽

Philip Mayne ◽

Nuala Murphy

Keyword(s):

Thyroid Gland ◽

Congenital Hypothyroidism ◽

Thyroid Tissue ◽

Thyroid Stimulating Hormone ◽

Thyroid Ultrasound ◽

Free T4 ◽

Median Serum ◽

Thyroid Glands ◽

Rule Out

Scintigraphy using technetium-99m (99mTc) is the gold standard for imaging the thyroid gland in infants with congenital hypothyroidism (CHT) and is the most reliable method of diagnosing an ectopic thyroid gland. One of the limitations of scintigraphy is the possibility that no uptake is detected despite the presence of thyroid tissue, leading to the spurious diagnosis of athyreosis. Thyroid ultrasound is a useful adjunct to detect thyroid tissue in the absence of 99mTc uptake. Aims: We aimed to describe the incidence of sonographically detectable in situ thyroid glands in infants scintigraphically diagnosed with athyreosis using 99mTc and to describe the clinical characteristics and natural history in these infants. Methods: The newborn screening records of all infants diagnosed with CHT between 2007 and 2016 were reviewed. Those diagnosed with CHT and athyreosis confirmed on scintigraphy were invited to attend a thyroid ultrasound. Results: Of the 488 infants diagnosed with CHT during the study period, 18/73 (24.6%) infants with absent uptake on scintigraphy had thyroid tissue visualised on ultrasound (3 hypoplastic thyroid glands and 15 eutopic glands). The median serum thyroid-stimulating hormone (TSH) concentration at diagnosis was significantly lower than that in infants with confirmed athyreosis (no gland on ultrasound and no uptake on scintigraphy) (74 vs. 270 mU/L), and median free T4 concentration at diagnosis was higher (11.9 vs. 3.9 pmol/L). Six of 10 (60%) infants with no uptake on scintigraphy but a eutopic gland on ultrasound had transient CHT. Conclusion: Absent uptake on scintigraphy in infants with CHT does not rule out a eutopic gland, especially in infants with less elevated TSH concentrations. Clinically, adding thyroid ultrasound to the diagnostic evaluation of infants who have athyreosis on scintigraphy may avoid committing some infants with presumed athyreosis to lifelong levothyroxine treatment.

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