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.

Graves’ disease and recurrence in ectopic thyroid tissue after total thyroidectomy

2021 ◽  
Vol 14 (7) ◽  
pp. e243313
Author(s):  
Clara Cunha ◽  
Catia Ferrinho ◽  
Catarina Saraiva ◽  
João Sequeira Duarte
Keyword(s):  
Total Thyroidectomy ◽  
Radioactive Iodine ◽  
Thyroid Tissue ◽  
Neck Mass ◽  
Thyroid Stimulating Hormone ◽  
Ectopic Thyroid ◽  
Treatment Withdrawal ◽  
Graves Disease ◽  
Receptor Antibodies ◽  
Levothyroxine Treatment

We report a case of a 46-year-old woman who presented with a midline neck mass 2 years after total thyroidectomy for Graves’ disease. Despite levothyroxine treatment withdrawal, she remained biochemically with subclinical hyperthyroidism. Her thyroid stimulating hormone receptor antibodies were consistently elevated. Neck ultrasonography revealed an infrahyoid solid nodule and pertechnetate scintigraphy confirmed an increased uptake at the same level, without any uptake in the thyroid bed. Treatment with methimazole 5 mg/day was initiated with clinical improvement and achievement of euthyroidism. After that, she received 10 mCi of radioactive iodine. Since then, she experienced regression of the neck mass and is doing well on a replacement dose of levothyroxine. Recurrence of Graves’ disease in ectopic thyroid following total thyroidectomy is extremely rare. This diagnose should be considered in patients who underwent total thyroidectomy and remained with thyrotoxicosis despite decreasing the levothyroxine dose.

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 Developing anterior mediastinum mass after orthotopic thyroidectomy: a case report

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.

scholarly journals Submandibular ectopic thyroid gland: an uncommon presentation

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.

Scintigraphic Demonstration of Ectopic Thyroid Tissue in a Thyroglossal Duct Cyst in the Presence of a Normal Thyroid

2011 ◽  
Vol 36 (12) ◽  
pp. 1142-1143 ◽  
Author(s):  
Sampath Santhosh ◽  
Bhagwant Rai Mittal ◽  
Koramadai Karuppusamy Kamaleshwaran ◽  
Rahul Parghane ◽  
Anish Bhattacharya ◽  
...  
Keyword(s):  
Thyroid Tissue ◽  
Thyroglossal Duct Cyst ◽  
Ectopic Thyroid ◽  
Duct Cyst ◽  
Thyroglossal Duct ◽  
Normal Thyroid ◽  
Ectopic Thyroid Tissue

Graves' Disease Unmasking Ectopic Thyroid Tissue

Thyroid ◽  
2004 ◽  
Vol 14 (1) ◽  
pp. 83-84 ◽  
Author(s):  
Milena Braga-Basaria ◽  
Audrey Liu ◽  
Theresa L. Nicol ◽  
Shehzad Basaria
Keyword(s):  
Thyroid Tissue ◽  
Ectopic Thyroid ◽  
Graves Disease ◽  
Ectopic Thyroid Tissue
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