scholarly journals Redefining Anatomy in a Case of Midline Subhyoid Ectopic Thyroid

2012 ◽  
Vol 3 (3) ◽  
pp. 179-181
Author(s):  
Kiran M Naik
Keyword(s):  
Thyroid Gland ◽  
Preoperative Evaluation ◽  
Thyroid Cartilage ◽  
Thyroid Tissue ◽  
Thyroid Function Test ◽  
Ectopic Thyroid ◽  
Thyroglossal Cyst ◽  
Duct Cyst ◽  
Thyroid Mass ◽  
Good Cosmetic

ABSTRACT Ectopic thyroid is an uncommon embryological aberration of the thyroid descent. Subhyoid median ectopic thyroid gland is a result of incomplete descent of the thyroid anlage and is characterized by a cosmetically unacceptable ovoid mass of thyroid tissue in the midline overlying the thyroid cartilage and thyrohyoid membrane. A normally placed thyroid gland is not detectable and in most cases all functioning thyroid tissue is located within the mass. Usually it is mistaken for a thyroglossal cyst and excised. Severe myxedema follows removal. Many cases have been reported in the literature, none of which was recognized prior to operation. All patients were operated upon for removal of a thyroglossal duct cyst. The diagnosis was missed at operation and in these cases severe myxedema was universal. The cause of the myxedema was not always immediately recognized. Therefore, many diagnostic tests including thyroid function test, ultrasound of the neck and thyroid scanning had been recommended in the preoperative evaluation of a thyroglossal cyst. Here, we present a case of ectopic thyroid mass which was the only thyroid tissue present in the neck. So division and repositioning of the thyroid mass thereby redefining the anatomy was done with good cosmetic result. How to cite this article Naik KM. Redefining Anatomy in a Case of Midline Subhyoid Ectopic Thyroid. Int J Head and Neck Surg 2012;3(3):179-181.

scholarly journals Papillary Thyroid Carcinoma Within Thyroglossal Duct Cyst

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A895-A896
Author(s):  
Raghda Al Anbari ◽  
Majlinda Xhikola ◽  
Sushma Kadiyala
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Thyroid Cartilage ◽  
Thyroid Tissue ◽  
Neck Mass ◽  
Thyroglossal Duct Cyst ◽  
Papillary Thyroid ◽  
Anterior Neck ◽  
Duct Cyst ◽  
Thyroglossal Duct

Abstract A 55-year-old female with medical history of hypothyroidism and fibrocystic disease of the breast presented with complains of a painful anterior neck mass, difficulty swallowing and hoarseness of the voice. Symptoms had progressed over a period of 5 months. CT neck with contrast indicated the presence of an ectopic thyroid tissue anterior to the thyroid cartilage measuring approximately 1.7 x 1.2 x 3.1 cm, with indistinct inferior margins and internal calcifications. The hyoid bone or thyroid cartilage had no irregularities. The thyroid gland itself was unremarkable except for small complex thyroid nodules in both lobes. No masses within the pharynx or larynx were noted. Family history was significant for lymphoma in her father. On physical exam, a hard, mobile right anterior neck mass was appreciated. Labs showed normal TSH of 1.05 uIU/mL and normal free T4 of 1.2 ng/dL. Further evaluation with a dedicated neck US showed a right submandibular mass, superior to the thyroid, lobulated and heterogeneous measuring 2.0 x 1.0 x 2.3 cm with multiple areas of calcifications and internal Doppler flow. The thyroid gland had normal size and texture with bilateral sub centimeter non-concerning nodules. After ENT evaluation and an unremarkable flexible fiberoptic nasolaryngoscope, patient underwent surgical excisional biopsy of the neck mass. Pathology was consistent with thyroglossal duct cyst with the presence of thyroid follicles. An incidental finding of a 0.9 cm papillary microcarcinoma was noted, which was encapsulated with focal extracapsular follicular structures showing papillary nuclear features with no perineural or lymphovascular invasion. The tumor cells were immunoreactive for TTF-1 and PAX8. Development of papillary thyroid cancer within the thyroglossal duct cyst is a rare event, reportedly occurring in 1% of thyroglossal duct cysts. There are no well-established management guidelines. Current management strategies consist of monitoring with serial neck ultrasound versus total thyroidectomy with consideration of postsurgical I-131 treatment, based on pathology results. Our patient opted for undergoing total thyroidectomy.

scholarly journals Ectopic Papillary Carcinoma in the Midline Neck Accompanied by a Benign Thyroid Gland

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Lauran Evans ◽  
SeHoon Park ◽  
Christie Elliott ◽  
Courtney Garrett
Keyword(s):  
Thyroid Gland ◽  
Unusual Case ◽  
Thyroid Tissue ◽  
Thyroglossal Duct Cyst ◽  
The Body ◽  
Ectopic Thyroid ◽  
Duct Cyst ◽  
Thyroglossal Duct ◽  
Ectopic Thyroid Tissue ◽  
Benign Thyroid

Ectopic thyroid tissue can deposit anywhere in the body. There are several cases reporting papillary thyroid carcinoma (PTC) arising from ectopic tissues; however, these cases largely presented with primary PTC within the native thyroid gland as well. Alternatively, some cases report of PTC found solely in an ectopic thyroglossal duct cyst, but reports of isolated malignancy in other types of ectopic thyroid tissue with normal native tissue are sparse throughout the literature. Here, we present an unusual case of PTC in the midline anterior neck that does not appear to be consistent with a thyroglossal duct cyst, accompanied by a completely benign native thyroid gland, of which only few cases have been reported.

Isolated thyroid carcinoma in an ectopic thyroid tissue

2021 ◽  
Vol 14 (2) ◽  
pp. e239738
Author(s):  
Gokulnath Nambiar ◽  
Harish Eshwarappa ◽  
Hema Kini ◽  
Dileep Chidanand
Keyword(s):  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Preoperative Evaluation ◽  
Thyroid Tissue ◽  
Nodal Metastasis ◽  
Ectopic Thyroid ◽  
Rare Entity ◽  
Normal Thyroid ◽  
Ectopic Thyroid Tissue ◽  
Sistrunk’S Procedure

Ectopic thyroid tissue (ETT) is a rare developmental abnormality due to aberrant embryogenesis of the thyroid gland. Although rare (<1%), papillary thyroid carcinoma (PTC) is the most common malignant transformation seen. A 34-year-old man presented with neck nodal swelling, on preoperative evaluation, was found to have PT) in ETT with the normal thyroid gland and nodal metastasis. The patient underwent surgery for PTC along with Sistrunk’s procedure and the histopathology revealed ectopic thyroid carcinoma with a normal thyroid and lymph nodal metastasis. Although a rare entity, the possibility of an ectopic thyroid carcinoma should be considered in differentiated cancers with neck nodes in the setting of a normal thyroid gland. Clinical suspicion and radiological imaging would help improve the preoperative diagnosis which in turn alters the management and thereby providing a better outcome to the patient.

scholarly journals Ectopic Thyroid Tissue in the Thyroglossal Cyst Duct: Rare Clinical Entity with Review of Literature

2013 ◽  
Vol 5 (2) ◽  
pp. 39-44 ◽  
Author(s):  
Sumit Gupta ◽  
Rajshekar Halkud ◽  
KT Siddappa ◽  
KC Sunil ◽  
Jagdish Sarvadyna ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Tissue ◽  
Neck Region ◽  
Clinical Entity ◽  
Ectopic Thyroid ◽  
Rare Clinical Entity ◽  
Review Of Literature ◽  
Thyroglossal Cyst ◽  
Ectopic Thyroid Tissue ◽  
Radioiodine Ablation

ABSTRACT The ectopic thyroid tissue is a rare developmental abnormality during embryogenesis where the thyroid gland passes from floor of the primitive foregut to its final pretracheal position. Its very important to verify the presence of a normally located normally functioning thyroid gland, thus excluding the possibility of an ectopic thyroid gland which resembles a TDC. A 12-year-old female presented to us with swelling in the midline of the neck region since 1 year. The mass moved with swallowing and protrusion of the tongue. On aspiration biopsy, a colloid material with cyst was confirmed. Imaging showed no orthotopic thyroid tissue on sonography and scintigraphy. No surgical intervention was done and as the patient was hypothyroid, levothyroxine replacement was given and the patient was advised for followup regularly. Hormonal estimation to rule out hypothyroid status and thyroid scintigraphy to detect the ectopic tissue and to see the presence of the normal orthotopic thyroid are essential investigations in evaluating thyroglossal cyst. Surgery is the treatment of choice in symptomatic lingual thyroids, with a role for radioiodine ablation in recurrent disease. Head and neck surgeons should evaluate ectopic thyroid as a differential diagnosis while evaluating mass in the midline as well as lateral neck. How to cite this article Naik SM, Halkud R, Madhu SD, Chavan P, Siddappa KT, Gupta S, Sunil KC, Moorthy S, Sinha P, Sarvadyna J. Ectopic Thyroid Tissue in the Thyroglossal Cyst Duct: Rare Clinical Entity with Review of Literature. World J Endoc Surg 2013;5(2):39-44.

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

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.

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 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 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.

scholarly journals Ectopic thyroid tissue presenting as an external auditory canal mass

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>

scholarly journals Role of Tc-99m pertechnetate thyroid scintigraphy in evaluation of lingual and midline neck swellings

2018 ◽  
Vol 6 (3) ◽  
pp. 842
Author(s):  
Bhairavi Mohit Bhatt ◽  
Shwetal Uday Pawar ◽  
Anuja Anand ◽  
Mangala Kedar Ghorpade ◽  
Suruchi Suresh Shetye
Keyword(s):  
Thyroid Tissue ◽  
Thyroglossal Duct Cyst ◽  
Neck Swelling ◽  
Thyroid Scintigraphy ◽  
Thyroglossal Cyst ◽  
Duct Cyst ◽  
Thyroglossal Duct ◽  
Technetium 99M ◽  
Ectopic Tissue

Background: The ectopic thyroid tissue in thyroglossal cyst or suprahyoid swelling is one of most important differential to be diagnosed. The purpose of this study was to find out role of Technetium-99m Pertechnetate Thyroid Scintigraphy (TS) to detect functioning thyroid tissue in ectopic locations presenting as midline neck swelling.Methods: A retrospective observational study was done where 26 subjects presenting with midline neck swelling were included. These subjects were injected with 1-5MBq/kg of Technetium-99m Pertechnetate to perform the TS. The uptake of tracer in the midline neck swelling and in other ectopic location was assessed. The comparison with Ultrasound (USG) was also done.Results: 12 (46.15%) subjects presented with infra hyoid swelling and rest 14 (53.85%) presented with supra hyoid and submental swelling. 33.3% subjects presenting with thyroglossal duct cyst showed functioning thyroid tissue. Also 4 subjects showed dual functioning ectopic tissue. USG an TS showed concordant results for detecting thyroid tissue in ectopic location (p=0.68). However, TS performed better to detect ectopically located thyroid tissue (p=0.0086).Conclusions: USG and TS showed similar results to detect thyroid tissue in normal location. However, TS is better to detect topically located thyroid tissue. TS adds information of functioning thyroid tissue during workup of midline neck swelling. 

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