scholarly journals Dual ectopic thyroid associated with thyroid hemiagenesis

2018 ◽  
Vol 2018 ◽  
Author(s):  
Shigenori Nakamura ◽  
Teruyuki Masuda ◽  
Masatoshi Ishimori
Keyword(s):  
Congenital Hypothyroidism ◽  
Hormone Replacement ◽  
Thyroid Tissue ◽  
Neck Mass ◽  
Left Lobe ◽  
Ectopic Thyroid ◽  
List Type ◽  
Ectopic Thyroid Tissue ◽  
Thyroid Hemiagenesis ◽  
Dual Ectopic Thyroid

Summary We report a case of a 15-year-old girl with a midline neck mass that was first noted 2 or 3 years previously. She had been treated with levothyroxine (L-T4) for congenital hypothyroidism until 11 years of age. Ultrasonography revealed an atrophic right thyroid (1.0 × 1.6 × 2.6 cm in size) and a mass (2.3 × 1.0 × 3.5 cm in size) in the upper part of the neck. No left lobe of the thyroid was detected. On further evaluation, Tc-99m pertechnetate thyroid scintigraphy and CT showed ectopic thyroid tissue in the lingual region and infrahyoid region. Thus, she was diagnosed as having dual ectopic thyroid and thyroid hemiagenesis. The atrophic right thyroid was thought be non-functional. Treatment with L-T4 was started to reduce the size of the dual ectopic thyroid tissue. This may be the first reported case of dual ectopic thyroid associated with hemiagenesis detected only by ultrasonography. Learning points: Ultrasonography can confirm the presence or absence of orthotopic thyroid tissue in patients with ectopic thyroid. The cause of congenital hypothyroidism should be examined. Clinical manifestation of ectopic thyroid may appear when the treatment with L-T4 is discontinued. Annual follow-up is needed in all children when their thyroid hormone replacement is stopped.

scholarly journals Lingual thyroid gland: it’s time for awareness

2020 ◽  
Vol 2020 ◽  
Author(s):  
Nicolás Cruz-Dardíz ◽  
Nadyeschka Rivera-Santana ◽  
Marina Torres-Torres ◽  
Héctor Cintrón-Colón ◽  
Shayanne Lajud ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Hormone Replacement ◽  
Thyroid Tissue ◽  
Size Reduction ◽  
Ectopic Thyroid ◽  
Lingual Thyroid ◽  
List Type ◽  
Management Options ◽  
Ectopic Thyroid Tissue ◽  
Ectopic Tissue

Summary Lingual thyroid (LT) gland is the most common type of ectopic thyroid tissue, but it is an extremely rare presentation. We present a case of a 41-year-old Hispanic female patient complaining of dysphonia and dysphagia. As part of the evaluation, fiber optic flexible indirect laryngoscopy (FIL) was performed which revealed a mass at the base of the tongue. The morphological examination was highly suspicious for ectopic thyroid tissue and the diagnosis was confirmed with neck ultrasound and thyroid scintigraphy. Although the patient presented subclinical hypothyroidism, levothyroxine therapy was initiated with a favorable response which included resolution of symptoms and mass size reduction. Our case portrays how thyroid hormone replacement therapy (THRT) may lead to a reduction in the size of the ectopic tissue and improvement of symptoms, thus avoiding the need for surgical intervention which could result in profound hypothyroidism severely affecting the patients’ quality of life. Learning points: Benign LT and malignant LT are indistinguishable clinically and radiographically for which histopathology is recommended. THRT, radioactive iodine 131 (RAI) therapy, and surgical excision are potential management options for LT. THRT may lead to size reduction of the ectopic tissue and resolution of symptoms avoiding surgical intervention.

scholarly journals Recurrent Graves’ Disease in Thyroglossal Duct Following Total Thyroidectomy

2021 ◽  
pp. 1-3
Author(s):  
John Petrie IV ◽  
John Petrie IV ◽  
Arvind Manisundaram ◽  
Irene Yu ◽  
Steven Schwaitzberg
Keyword(s):  
Total Thyroidectomy ◽  
Surgical Resection ◽  
Hormone Replacement ◽  
Thyroid Tissue ◽  
Neck Mass ◽  
Ectopic Thyroid ◽  
Graves Disease ◽  
Thyroglossal Duct ◽  
Ectopic Thyroid Tissue ◽  
Thyroglossal Duct Remnant

Introduction: A 46-year-old female with a past medical history of Graves’ disease refractory to medical management, thus requiring total thyroidectomy presented to clinic for recurrence of her hyperthyroidism and an increasing midline neck mass two years after her index operation. Case Description: CT imaging of the neck mass revealed a locally extensive enhancing abnormality immediately anterior to the hyoid bone within the infrahyoid muscles measuring 1.4x.1.9x4.0 cm. This was consistent with an exceedingly rare proliferation of a thyroglossal duct remnant secondary to recurrence of the patient’s Graves’ disease. The patient was treated with surgical resection of the neck mass shown to be ectopic Graves’ activated thyroid tissue by pathology. The patient was restarted on thyroid hormone replacement therapy and has remained euthyroid to date following surgical resection. Conclusion: The incidence of this event is estimated to be approximately one per a million persons and thus is a rare occurrence in endocrinology. This case highlights the potential shortcomings of surgical management of Graves’ disease. Following surgical resection, the autoimmune status of the patient remains unchanged. Ectopic thyroid tissue can be found anywhere along the embryologic descent of the thyroid gland and as low as the mediastinum. Thus, patients treated with total thyroidectomy should still be monitored regularly for recurrence of Graves’ disease secondary to ectopic thyroid tissue.

scholarly journals Thyroglossal Duct Cyst Papillary Carcinoma With Airway Compromise

2021 ◽  
pp. 014556132110220
Author(s):  
Po-Kai Huang ◽  
Li-Chun Hsieh ◽  
Yi-Shing Leu
Keyword(s):  
Symptom Relief ◽  
Thyroid Tissue ◽  
Neck Mass ◽  
Thyroglossal Duct Cyst ◽  
Ectopic Thyroid ◽  
Airway Compromise ◽  
Duct Cyst ◽  
Complete Excision ◽  
Thyroglossal Duct ◽  
Ectopic Thyroid Tissue

Thyroglossal duct cysts are typically benign and usually asymptomatic. Malignant transformation is uncommon. Intralaryngeal extension is rare and results in dysphonia or dyspnea. There is no literature nowadays reporting the thyroglossal duct cyst carcinoma combining the clinical features of intralaryngeal extension. The authors present a case of progressive hoarseness and midline neck mass for 2 years. The laryngoscope and computed tomography revealed a 6-cm thyroglossal duct cyst containing ectopic thyroid tissue with intralaryngeal extension and causing airway obstruction. Complete excision with Sistrunk operation revealed papillary thyroid carcinoma. The patient resumed normal phonation after the surgery. There was no evidence of tumor recurrence and no hoarseness or dyspnea at 6 months follow up. This is the first reported case of a huge thyroglossal duct cyst carcinoma with intralaryngeal extension causing airway compromise. Complete excision of tumor is essential and vital to the symptom relief. A thyroglossal duct cyst carcinoma with endolaryngeal involvement should be considered in the differential diagnosis when the case has a massive midline neck mass with ectopic thyroid tissue and develops dyspnea or hoarseness concurrently.

scholarly journals Submandibular ectopic thyroid tissue and concurrent thyroid hemiagenesis

2021 ◽  
Vol 6 (1) ◽  
pp. 91-95
Author(s):  
Marie-Louise Uhre Hansen ◽  
Thomas Vedtofte ◽  
Irene Wessel ◽  
Mikkel Kaltoft
Keyword(s):  
Thyroid Tissue ◽  
Ectopic Thyroid ◽  
Ectopic Thyroid Tissue ◽  
Thyroid Hemiagenesis

scholarly journals Incidental Finding of Dual Ectopic Thyroid on Computed Tomography Angiography

2017 ◽  
Vol 7 ◽  
pp. 30 ◽  
Author(s):  
Antonio Pierro ◽  
Savino Cilla ◽  
Pietro Modugno ◽  
Giuseppina Sallustio
Keyword(s):  
Computed Tomography ◽  
Patient Management ◽  
Incidental Finding ◽  
Thyroid Tissue ◽  
Ectopic Thyroid ◽  
Lingual Thyroid ◽  
Ectopic Thyroid Tissue ◽  
Ectopic Tissue ◽  
Normal Thyroid Function ◽  
Dual Ectopic Thyroid

The presence of simultaneous two ectopic foci of thyroid tissue (dual ectopic thyroid) is rare, and few cases have been reported in the literature. The ectopic thyroid tissue is an extremely uncommon embryological aberration due to the alterations occurring during the embryological development with incomplete migration of thyroid precursors. Commonly ectopic thyroid tissue is a midline structures, but the lateral location is possible but very rare. Ectopic thyroid is common in women and can vary in size from a microscopic focus to a few centimeters. The normal process of migration of the thyroid can be interrupted at various levels determining a lingual ectopy, a sublingual ectopic, prelaryngeal ectopy, or mediastinic ectopy. Intrathoracic and subdiaphragmatic organs are other sites where the ectopic thyroid tissue may be present. In most of the cases, ectopic tissue is a lingual thyroid and this condition can be totally asymptomatic, discovered incidentally, or occurs with symptoms such as dysphonia, dysphagia, dyspnea, and hemoptysis. Sublingual or suprahyoid ectopia is rare and even rarer are the cases of two foci of ectopic thyroid tissue simultaneously present. On imaging, the ectopic tissue shows the same characteristics of orthotopic thyroid tissue and similarly can undergo goiterous and cancerous transformation. We report a case of incidental dual ectopic thyroid in lingual and suprahyoid level in a 72-year-old female patient, asymptomatic and with normal thyroid function, who underwent computed tomography (CT) angiography before vascular surgery for the treatment of carotid stenosis. The presence of a lingual thyroid can lead to a difficult and dangerous intubation, with possible fatal consequences. For this reason, the discovery of these abnormalities has totally changed the patient management who has been subjected to endovascular treatment, instead to the classical surgery.

scholarly journals Ectopic thyroid tissue presenting as a new neck mass in a pediatric patient

2019 ◽  
Vol 14 (1) ◽  
pp. 55-57
Author(s):  
Sean Carlson ◽  
Lauren Campbell ◽  
Emily Janitz
Keyword(s):  
Pediatric Patient ◽  
Thyroid Tissue ◽  
Neck Mass ◽  
Ectopic Thyroid ◽  
Ectopic Thyroid Tissue

Ectopic thyroid tissue presenting as a midline neck mass

1996 ◽  
Vol 34 (1-2) ◽  
pp. 141-148 ◽  
Author(s):  
Angela Damiano ◽  
Alex B. Glickman ◽  
John S. Rubin ◽  
Alan F. Cohen
Keyword(s):  
Thyroid Tissue ◽  
Neck Mass ◽  
Ectopic Thyroid ◽  
Ectopic Thyroid Tissue

scholarly journals Scintigraphic Detection of Dual Ectopic Thyroid Tissue: Experience of a Chinese Tertiary Hospital

PLoS ONE ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. e95686 ◽  
Author(s):  
Zhaowei Meng ◽  
Shanshan Lou ◽  
Jian Tan ◽  
Qiang Jia ◽  
Rongxiu Zheng ◽  
...  
Keyword(s):  
Thyroid Tissue ◽  
Tertiary Hospital ◽  
Ectopic Thyroid ◽  
Ectopic Thyroid Tissue ◽  
Dual Ectopic Thyroid

scholarly journals MON-461 A Rare Case of Thyroglobulin Deficiency with Ectopic Thyroid Tissue

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Sandhya Venkataraman ◽  
Sharmila Koshy
Keyword(s):  
Thyroid Tissue ◽  
Neck Mass ◽  
Ectopic Thyroid ◽  
Follicular Cell ◽  
Ectopic Thyroid Tissue ◽  
Thyroid Uptake ◽  
Thyroid Goiter ◽  
Levothyroxine Replacement ◽  
The Right ◽  
Benign Thyroid

Abstract Background: The production of thyroglobulin (TG) is initiated by TSH binding to the TSH receptor leading to the transcription and production of TG protein. TG protein then gets transported to the lumen of the follicular cell where its tyrosine amino acids get iodinated and coupled to form T3 and T4. TG deficiency is a rare autosomal recessive genetic condition characterized by congenital thyroid goiter, increased thyroid uptake and primary hypothyroidism. Clinical Case: A 21 year old South Asian female with a history of TG deficiency, hypothyroidism, and thyroid goiter status post thyroidectomy presented with a right sided neck mass. She was diagnosed hypothyroidism with a goiter at the age of five. Levothyroxine replacement was initiated and she had normal growth and development. At the age of ten upon transferring care to our health network, there was concern for enlargement of the goiter. Labs showed TSH of 2.85 uIU/mL (normal: 0.36-3.74 ulU/mL), thyroid binding globulin of 18.2 ug/mL (normal: 13-30 ug/mL), TG antibody less than 20 IU/mL (normal: less than 40 lU/mL) and TG level less than 0.2 ng/mL (normal: less than 55 ng/mL). Thyroid uptake and scan showed overall increased uptake. Genetic studies revealed homozygous mutation of thyroglobulin deficiency. Further history obtained confirmed patient’s parents were first cousins with heterozygous thyroglobulin mutations. Due to enlarging multinodular goiter with thyroid gland measuring 6.2 cm x 4 cm on the right and 6.2 x 3.6 cm on the left, total thyroidectomy was completed in 2012. Pathology showed benign thyroid tissue. In May 2019 the patient skipped levothyroxine replacement due to lapse in prescription refill and TSH increased to 28 ulU/mL. Around that time, she noticed an enlarging right sided neck mass. MRI of the neck showed an enhancing mass posterior to the submandibular gland measuring 1.6 x 1.4 cm. Fine needle aspiration in August 2019, showed a mixed population of lymphocytes and few benign appearing glandular cells. Pathology obtained after resection of the right neck mass in September 2019 revealed benign thyroid tissue with no lymphoid tissue, staining positive for TTF-1 and PAX-8. Conclusion: TG deficiency has an incidence of 1:100,000 live births and is more common in cases of genetic consanguinity. There have been over fifty mutations of varying penetrance identified leading to differing consequences in TG production and processing. These mutations can cause structural changes in the TG protein, decreased tyrosine residue on TG leading to poor iodination and ineffective TG transport within the follicular cell. We propose that the right sided neck mass was regrowth of residual thyroid tissue due to the stimulatory effect of TSH after missed doses of levothyroxine caused TSH elevation. Our case is the first of TG deficiency wherein the patient developed ectopic thyroid tissue proliferation after a period of thyroid hormone deficiency.

scholarly journals Submandibular Lateral Ectopic Thyroid Tissue: Ultrasonography, Computed Tomography, and Scintigraphic Findings

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Metin Çeliker ◽  
Fatma Beyazal Çeliker ◽  
Arzu Turan ◽  
Mehmet Beyazal ◽  
Hatice Beyazal Polat
Keyword(s):  
Computed Tomography ◽  
Thyroid Tissue ◽  
Neck Mass ◽  
Ectopic Thyroid ◽  
Follicle Cells ◽  
Pathological Examination ◽  
Submandibular Region ◽  
Ectopic Thyroid Tissue ◽  
Female Case ◽  
Enhanced Computed Tomography

Ectopic thyroid can be encountered anywhere between the base of tongue and pretracheal region. The most common form is euthyroid neck mass. Herein, we aimed to present the findings of a female case with ectopic thyroid tissue localized in the left submandibular region. A 44-year-old female patient, who underwent bilateral subtotal thyroidectomy four years ago with the diagnosis of multinodular goiter, was admitted to our hospital due to a mass localized in the left submandibular area that gradually increased in the last six months. Neck ultrasonography, contrast-enhanced computed tomography, and scintigraphic examination were performed on the patient. On thyroid scintigraphy with Tc-99m pertechnetate, thyroid tissue activity uptake showing massive radioactivity was observed in the normal localization of the thyroid gland and in the submandibular localization. The focus in the submandibular region was excised. Pathological examination of the specimen showed normal thyroid follicle cells with no signs of malignancy. The submandibular mass is a rarely encountered lateral ectopic thyroid tissue. Accordingly, ectopic thyroid tissue should also be considered in the differential diagnosis of masses in the submandibular region.

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