Thyroid ectopia: a case series

Ectopic thyroid is a form of thyroid dysgenesis and is defined as the presence of thyroid tissue in an abnormal location. Its prevalence is about 1 per 1,00, 000-3,00,000 people, rising to 1 per 4,000-8,000 patients with thyroid diseases. The most common sites of ectopic thyroid are lingual (90%) and anterior neck (10%). They are usually diagnosed with hypothyroidism with a mass with, or without pressure symptoms in the 2nd or 3rd decade of life when there is increased demand of thyroid hormone. Presence of two ectopic foci of thyroid tissue simultaneously is rare, and very few such cases of dual thyroid ectopia have been reported. We present a case series of 3 ectopic thyroid with 3 different clinical presentation. The first case is a 19-year-old boy who presented with clinical and biochemical overt hypothyroidism and was discovered to have only a sublingual ectopic thyroid gland. The second case is a 16-year-old girl who presented with dysphagia and on evaluation was found to have a dual ectopic thyroid gland in the lingual and sub lingual region. The third case is a 28-year-old women who presented with a sub hyoid swelling which on evaluation was diagnosed as a dual ectopic thyroid in the lingual and sub lingual region.

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Ectopic thyroid gland- presentation at childhood, adolescent and adult life

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v17i1.22503 ◽

2015 ◽

Vol 17 (1) ◽

pp. 116-124

Author(s):

Md Sunny Anam Chowdhury ◽

Mohshi Um Mokaddema ◽

Tanzina Naushin ◽

Simoon Salekin ◽

Nabeel Fahmi Ali ◽

...

Keyword(s):

Thyroid Gland ◽

Thyroid Tissue ◽

Adult Life ◽

Ectopic Thyroid ◽

Rare Entity ◽

Neck Swelling ◽

Anterior Neck ◽

Adult Age ◽

Body Sensation ◽

Dual Ectopic Thyroid

Ectopic thyroid is a rare entity that can appear at any age with different presentations. In this study we are reporting four cases of ectopic thyroid gland at different ages; two cases at childhood, one at adolescent and one at adult life. Among the two children, one having ectopic thyroid at the level of hyoid bone, presented with anterior neck swelling with no other symptom and another one having a lingual ectopic thyroid presented with features of hypothyroidism and obstructive features. The cases of adolescent and adult age are very rare cases of dual ectopic thyroid and ectopic thyroid tissue coexisting with normal thyroid gland respectively. Both of them presented with anterior neck swelling, with additional complaints of dysphagia and foreign body sensation by the adolescent patient. All the cases, ectopic thyroids were detected by Ultrasonogram and confirmed by radionuclide (99mTc) thyroid scan. DOI: http://dx.doi.org/10.3329/bjnm.v17i1.22503 Bangladesh J. Nuclear Med. 17(1): 116-124, January 2014

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Dual Ectopic Thyroid with Normally Located Thyroid: A Case Report

Journal of Thyroid Research ◽

10.4061/2011/159703 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 13

Author(s):

Bipul Kumar Choudhury ◽

Uma Kaimal Saikia ◽

Dipti Sarma ◽

Mihir Saikia ◽

Sarojini Dutta Choudhury ◽

...

Keyword(s):

World Literature ◽

Thyroid Tissue ◽

Thyroid Function Test ◽

Primary Hypothyroidism ◽

Ectopic Thyroid ◽

Rare Presentation ◽

Base Of Tongue ◽

Thyroid Ectopia ◽

Function Test ◽

Dual Ectopic Thyroid

Dual ectopic thyroid is a rare presentation of thyroid ectopia. Only a few cases have been reported in the world literature. Dual ectopic thyroid in the presence of a normally located thyroid is even rarer. We report a case of dual ectopic thyroid in the lingual and submandibular areas in a seventeen-year-old female with hypoplastic thyroid gland in its normal location. The patient presented with a midline swelling at the base of tongue with dysphagia. Thyroid function test revealed primary hypothyroidism. Ultrasonography of the neck showed hypoplastic thyroid in its normal location. A thyroid scan with Technetium-99 m pertechnate showed two intensely hyperfunctioning foci of ectopic thyroid tissue at a higher level in the midline consistent with dual ectopic thyroid, one at the base of tongue and the other in submental region. No uptake was seen in the normal bed.

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Peculiarities of the clinical course of hypothyroidism during pregnancy

Actual problems of modern medicine ◽

10.26565/2617-409x-2021-7-12 ◽

2021 ◽

Keyword(s):

Thyroid Gland ◽

Pregnant Women ◽

Hormone Replacement ◽

Thyroid Tissue ◽

The Body ◽

Overt Hypothyroidism ◽

Lactation Period ◽

Planning Stage ◽

Thyroid Pathology ◽

First Case

The article presents an analysis of resources about the course of thyroid pathology, specifically hypothyroidism, during pregnancy. This problem is of current interest, because hypothyroidism can cause infertility or miscarriage. This applies not only to overt but also to the subclinical one. The physiological changes that occur in the thyroid gland during pregnancy are described. Attention is drawn to the signs that can be mistaken for pathological. In addition, the reference values of hormonal thyroid parameters during pregnancy differ significantly from those in non-pregnant women. This should also be taken into account in the diagnosis of appropriate disorders. The presented resources data are illustrated by two clinical cases. The first case history demonstrates the deterioration of the autoimmune process on the background of the pregnancy. Interesting is the fact that this effect was delayed, ie during pregnancy, compensatory mechanisms created a proper supply of the body of a woman and two fetuses with thyroid hormones. At the same time, during lactation period there was a pronounced decompensation of the patient's condition, which was manifested by activation of autoimmune aggression against thyroid tissue with increasing titer of antithyroid antibodies, the development of overt hypothyroidism and deepening structural changes in the thyroid gland. The need for further follow-up of postpartum women with autoimmune thyroiditis is emphasized, even if no thyroid dysfunction has been reported throughout pregnancy. The second clinical case illustrates the importance of following the recommendations of the European and American thyroid associations regarding the level of thyroid-stimulating hormone (TSH) during pregnancy. When planning the first pregnancy of this patient, the doctor did not pay attention to the fact that TSH level, being within normal values for non-pregnant women, did not meet international guidelines for planning a pregnancy and its first trimester. This had extremely adverse consequences in the form of two miscarriages. The prescription of an appropriate hormone replacement therapy and careful monitoring of the patient both at the planning stage and throughout the pregnancy, led to the birth of a healthy baby. Thus, compliance with the principles of management and use of the proposed treatment regimens for pregnant women with thyroid pathology will ensure the normal course of pregnancy and the birth of a healthy child.

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A case of dual ectopic thyroid

International Surgery Journal ◽

10.18203/2349-2902.isj20173437 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2862

Author(s):

S. Zahir Hussain ◽

Muhamed Faizal Ayub

Keyword(s):

Thyroid Gland ◽

Short Stature ◽

Thyroid Tissue ◽

Ectopic Thyroid ◽

Single Patient ◽

Technetium 99M ◽

Ectopic Thyroid Tissue ◽

Uncommon Presentation ◽

Low Incidence ◽

Dual Ectopic Thyroid

The presence of two ectopic foci of thyroid tissue in a single patient is an uncommon presentation. Ectopic thyroid reportedly has a low incidence. We are reporting here a case of dual ectopic thyroid present in the lingual and sub hyoid region in a 33 years old lady with short stature and hypothyroidism. Ultrasonography of the neck had revealed no thyroid gland in its normal anatomical position. The presence of ectopic thyroid tissue in the lingual and sub hyoid region were confirmed with a technetium-99m sodium per technetate thyroid scan.

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MON-466 Dual Ectopic Thyroid with Normally Located Thyroid Gland in a Patient Presenting with Subclinical Hypothyroidism: A Case Report

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.363 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Stephen M Rueda ◽

Mark H Joven ◽

Nixon See ◽

Hossein Gharib

Keyword(s):

Thyroid Gland ◽

Subclinical Hypothyroidism ◽

Thyroid Cartilage ◽

Thyroid Tissue ◽

Deep Tendon Reflex ◽

Ectopic Thyroid ◽

Cystic Degeneration ◽

Free T4 ◽

Diagnostic Modality ◽

Dual Ectopic Thyroid

Abstract Background: Ectopic thyroid involves the presence of thyroid tissue in sites other than its normal anatomic location. Dual ectopic thyroid with normally located thyroid gland is extremely rare with only a few cases reported in the literature. Clinical Case: A 24-year-old female presented to the clinic with subclinical hypothyroidism (TSH of 10.54 uIU/ml [ref, 0.27–4.2] and free T4 of 12.96 pmol/L [ref, 12–22]). She noted a gradually enlarging submental mass during the preceding year, which had been present since her adolescent years. Examination was notable for a 2-cm firm, non-tender mass at the submental region that slightly moved with deglutition. The thyroid was not palpable in its normal location. The relaxation phase of the deep tendon reflex was prolonged. Repeat laboratory testing showed persistently elevated TSH of 13.3 uIU/ml and normal free T4 of 13.39 pmol/L. TPO antibody was normal. Thyroid ultrasonography showed a hypoplastic thyroid measuring 2.7 x 0.7 x 0.4 cm on the right and 3.0 x 0.7 x 0.4 cm on the left. A well-circumscribed complex nodule measuring 2.7 x 3.2 x 2.1 cm was noted on the submental region corresponding to the patient’s submental mass. Computed tomography of the neck with contrast showed two hyperdense foci - measuring 3.0 x 2.4 cm at the submental region and 1.4 x 1.2 cm at the base of the tongue. No enhancing thyroid tissue was seen anterior to the thyroid cartilage. 99mTechnetium-pertechnetate scan showed absent focal tracer uptake in the anterior neck and thorax. There were foci of increased tracer activity in the submental and lingual regions. Ultrasound-guided biopsy of the submental area showed cytomorphologic features of a colloid nodule with cystic degeneration (Bethesda Category II). The patient was started on levothyroxine and remained biochemically euthyroid afterwards. The submental neck mass reduced in size. Conclusion: Dual ectopic thyroid with normally located (eutopic) thyroid gland could present with subclinical hypothyroidism. There is no single diagnostic modality that would best identify dual ectopic thyroid; thus, thyroid scan, ultrasonography, CT scan and biopsy are recommended to be used complementarily. For patients with dual ectopic thyroid and hypothyroidism, levothyroxine replacement is recommended to reduce the size of ectopic thyroid and render the patient euthyroid.

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Developing anterior mediastinum mass after orthotopic thyroidectomy: a case report

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00377-x ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Rita Meira Soares Camelo ◽

José Maria Barros

Keyword(s):

Thyroid Gland ◽

Total Thyroidectomy ◽

Thyroid Tissue ◽

Anterior Mediastinum ◽

Ectopic Thyroid ◽

Ectopic Thyroid Tissue ◽

Ectopic Tissue ◽

Thyroid Scan ◽

Imaging Results ◽

Adjacent Structures

Abstract Background Ectopic thyroid tissue is a rare embryological aberration described by the occurrence of thyroid tissue at a site other than in its normal pretracheal location. Depending on the time of the disruption during embryogenesis, ectopic thyroid may occur at several positions from the base of the tongue to the thyroglossal duct. Ectopic mediastinal thyroid tissue is normally asymptomatic, but particularly after orthotopic thyroidectomy, it might turn out to be symptomatic. Symptoms are normally due to compression of adjacent structures. Case presentation We present a case of a 66-year-old male submitted to a total thyroidectomy 3 years ago, due to multinodular goiter (pathological results revealed nodular hyperplasia and no evidence of malignancy), under thyroid replacement therapy. Over the last year, he developed hoarseness, choking sensation in the chest, and shortness of breath. Thyroid markers were unremarkable. He was submitted to neck and thoracic computed tomography, magnetic resonance imaging, and radionuclide thyroid scan. Imaging results identified an anterior mediastinum solid lesion. A radionuclide thyroid scan confirmed the diagnosis of ectopic thyroid tissue. The patient refused surgery. Conclusions Ectopic thyroid tissue can occur either as the only detectable thyroid gland tissue or in addition to a normotopic thyroid gland. After a total thyroidectomy, thyroid-stimulating hormone can promote a compensatory volume growth of previously asymptomatic ectopic tissue. This can be particularly diagnosis challenging since ectopic tissue can arise as an ambiguous space-occupying lesion.

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Submandibular ectopic thyroid gland: an uncommon presentation

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00124-7 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Inès Riahi ◽

Rim Fradi ◽

Ibtissem Ben Nacef ◽

Ahlem Blel

Keyword(s):

Thyroid Gland ◽

Thyroid Tissue ◽

Ectopic Thyroid ◽

Lingual Thyroid ◽

Submandibular Region ◽

Case Presentation ◽

Thyroglossal Duct ◽

Common Presentation ◽

Ectopic Thyroid Tissue ◽

Uncommon Presentation

Abstract Background Ectopic thyroid is a developmental anomaly of the thyroid gland of embryological origin. Instead of having a pretracheal situation, thyroid tissue is elsewhere, most commonly in the median cervical line along the course of the thyroglossal duct. Lingual thyroid is the most common presentation. Ectopic thyroid tissue in the submandibular region has been rarely reported. Case presentation We report herein a case of a 65-year-old man admitted to our department with a complaint of a painless swelling in the left submandibular region. Conclusions Thyroid gland ectopia should be considered among the differential diagnoses of submandibular swelling. Ectopic thyroid tissue can present with the same pathology affecting the normal thyroid gland such as malignancy and hyperthyroidism.

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Ectopic thyroid tissue presenting as an external auditory canal mass

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190066 ◽

2019 ◽

Vol 5 (2) ◽

pp. 476

Author(s):

Nishikanta Verma ◽

Samuel Devanesan Abishegam ◽

Abdul Razak Bin Haji Ahmad

Keyword(s):

Thyroid Gland ◽

Thyroid Tissue ◽

The Body ◽

Ectopic Thyroid ◽

Thyroid Function Tests ◽

External Ear ◽

Ear Canal ◽

Developmental Defects ◽

External Ear Canal ◽

Ectopic Thyroid Tissue

<p class="abstract">An ectopic thyroid is a rare occurrence with a majority of ectopic thyroid tissue located in the lingual region or in the midline. The abnormal sites represent developmental defects in migration from the floor of the primitive foregut at the foramen caecum of the tongue to the final pre-tracheal position of the gland. A few cases of ectopic thyroid tissue have also been reported from sites seemingly unrelated to the normal development of the thyroid gland. We report a case of ectopic thyroid in the external ear canal, which presented as a small reddish mass in the external ear canal. To the best of our knowledge, this is the first such reported case in literature and adds to the body of knowledge in such cases. Although such a finding is exceedingly rare, the authors recommend routine histopathology in all cases of polyps in the external canal and standard investigation for the status of the residual thyroid gland via isotope scans, ultrasonography or thyroid function tests.</p>

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