Lingual Thyroid with Hyperthyroidism in a Child: A Rare Presentation

ABSTRACT Lingual thyroid is the most common presentation of ectopic thyroid tissue (ETT). It is a rare condition presents in about 1 in 100,000 populations, more commonly is seen in females. It is even rarer in children. It is mainly associated with euthyroid or hypothyroid status; hyperthyroidism is rarely seen. Its management varies from surgical excision to medical management. Here, we present a case of lingual thyroid presenting with hyperthyroidism and its management. How to cite this article Rana K, Arora N, Wadhwa V, Bhargava E. Lingual Thyroid with Hyperthyroidism in a Child: A Rare Presentation. World J Endoc Surg 2015;7(2):36-38.

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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 in Submandibular Region in Pediatric Patient: A Case Report

Journal of Institute of Medicine ◽

10.3126/jiom.v42i3.37604 ◽

2020 ◽

Vol 42 (3) ◽

pp. 106-108

Author(s):

Rohita Bajracharya ◽

Heempali Dutta

Keyword(s):

Case Report ◽

Thyroid Gland ◽

Thyroid Tissue ◽

Surgical Excision ◽

Ectopic Thyroid ◽

Anatomical Location ◽

Rare Presentation ◽

Submandibular Region ◽

Normal Thyroid ◽

Ectopic Thyroid Tissue

Normal anatomical location of thyroid gland is anterior to trachea and larynx. Ectopic thyroid is rare presentation. Ectopic thyroid tissue in submandibular region is even more rare. This article reports a case of five year old child who presented with swelling in left submandibular region which was later diagnosed to be an ectopic thyroid gland with no thyroid tissue in thyroid bed. Although rare, physician should consider possibility of ectopic thyroid in patient presenting with submandibular mass. Ultrasonography should always be performed to confirm presence of normal thyroid gland if surgical excision is planned.

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Ectopic Thyroid Tissue: A Case Series

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v28i1.493 ◽

2013 ◽

Vol 28 (1) ◽

pp. 10-14 ◽

Cited By ~ 1

Author(s):

Somnath Saha ◽

Anirban Ghosh ◽

Sudipta Pal ◽

V Padmini Saha

Keyword(s):

Thyroid Tissue ◽

Case Series ◽

Retrospective Chart Review ◽

Surgical Excision ◽

The Body ◽

Ectopic Thyroid ◽

Lingual Thyroid ◽

Substitution Therapy ◽

Ectopic Thyroid Tissue ◽

Ectopic Tissue

Objective: To describe the clinical presentation and course of seven ectopic thyroid patients. Methods: Design: Retrospective Chart Review Setting: Tertiary Government Teaching Hospital Subjects: Seven patients Results: Five patients were female and two were male (ratio of 5:2). Three belonged to the 20 to 30 year-old age group, whereas two were below 10 years of age. All seven were biochemically hypothyroid and ectopic thyroid was found to be the only functioning thyroid tissue.Three patients were managed medically with levothyroxine, while ectopic thyroid was excised in four. Ectopic thyroid tissue was autotransplanted in two cases following excision. Conclusion: The ages of presentation in the present series correspond with the increased physiological demand of thyroid hormone. Thyroid substitution therapy is a must in the presence of clinical and/or biochemical hypothyroidism. Surgical excision should be avoided as far as possible especially if the ectopic tissue is the only functioning thyroid in the body. Surgery is required in selected cases presenting with obstructive symptoms or hemorrhage which are unresponsive to substitution therapy. Auto transplantation of the ectopic thyroid may not provide significant benefit to the patient and more research is warranted in this aspect. Keywords: ectopic thyroid, lingual thyroid, thyroid replacement therapy, ectopic thyroid surgery.

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Ultrasound Imaging of Cervical Anatomic Variants

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210127162328 ◽

2021 ◽

Vol 17 ◽

Author(s):

Michael Cordes ◽

Stephan Coerper ◽

Torsten Kuwert ◽

Christian Schmidkonz

Keyword(s):

Molecular Genetic ◽

Thyroid Tissue ◽

Preoperative Assessment ◽

Parathyroid Glands ◽

Ectopic Thyroid ◽

Lingual Thyroid ◽

Developmental Anomalies ◽

Ectopic Thyroid Tissue ◽

Anatomic Variants ◽

Developmental Variants

: Embryologic developmental variants of the thyroid and parathyroid glands may cause cervical anomalies that are detectable in ultrasound examinations of the neck. For some of these developmental variants, molecular genetic factors have been identified. Ultrasound, as the first-line imaging procedure, has proven useful in detecting clinically relevant anatomic variants. The aim of this article was to systematically summarize the ultrasound characteristics of developmental variants of the thyroid and parathyroid glands as well as ectopic thymus and neck cysts. Quantitative measures were developed based on our own findings and the respective literature. Developmental anomalies frequently manifest as cysts that can be detected by cervical ultrasound examinations. Median neck cysts are the most common congenital cervical cystic lesions, with a reported prevalence of 7% in the general population. Besides cystic malformations, developmental anomalies may appear as ectopic or dystopic tissue. Ectopic thyroid tissue is observed in the midline of the neck in most patients and has a prevalence of 1/100,000 to 1/300,000. Lingual thyroid accounts for 90% of cases of ectopic thyroid tissue. Zuckerkandl tubercles (ZTs) have been detected in 55% of all thyroid lobes. Prominent ZTs are frequently observed in thyroid lobes affected by autoimmune thyroiditis compared with normal lobes or nodular lobes (P = 0.006). The correct interpretation of the ultrasound characteristics of these variants is essential to establish the clinical diagnosis. In the preoperative assessment, the identification of these cervical anomalies via ultrasound examination is indispensable.

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Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity

Acta Endocrinologica ◽

10.1530/eje-11-0461 ◽

2011 ◽

Vol 165 (3) ◽

pp. 375-382 ◽

Cited By ~ 151

Author(s):

George Noussios ◽

Panagiotis Anagnostis ◽

Dimitrios G Goulis ◽

Dimitrios Lappas ◽

Konstantinos Natsis

Keyword(s):

Thyroid Gland ◽

Management Strategies ◽

Thyroid Tissue ◽

Rare Condition ◽

Ectopic Thyroid ◽

Rare Entity ◽

Developmental Defects ◽

Symptomatic Disease ◽

Ectopic Thyroid Tissue ◽

Radioiodine Ablation

Ectopic thyroid tissue is a rare entity resulting from developmental defects at early stages of thyroid gland embryogenesis, during its passage from the floor of the primitive foregut to its final pre-tracheal position. It is frequently found around the course of the thyroglossal duct or laterally in the neck, as well as in distant places such as the mediastinum and the subdiaphragmatic organs. Although most cases are asymptomatic, symptoms related to tumor size and its relationship with surrounding tissues may also appear. Any disease affecting the thyroid gland may also involve the ectopic thyroid, including malignancy. The clinician must distinguish between ectopic thyroid and metastatic deposits emerging from an orthotopic gland, as well as other benign or malignant masses. Thyroid scintigraphy plays the most important role in diagnosing ectopy, but ultrasonography contributes as well. In cases of symptomatic disease, surgery is the treatment of choice, followed by radioiodine ablation and levothyroxine suppression therapy in more refractory cases. This review provides current understanding about the wide clinical spectrum of this rare condition, also referring to optimal diagnostic approach, differential diagnosis, and management strategies.

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Thyroid Tissue Connected to Normally Located Thyroid Gland: Ectopic or Exophytic?

Case Reports in Otolaryngology ◽

10.1155/2012/681823 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Erol Keles ◽

Sule Ozkara ◽

Turgut Karlidag ◽

İbrahim Hanifi Ozercan

Keyword(s):

Thyroid Gland ◽

Needle Biopsy ◽

Thyroid Tissue ◽

Surgical Excision ◽

Fine Needle Biopsy ◽

Ectopic Thyroid ◽

Fibrous Band ◽

Fine Needle ◽

Ectopic Thyroid Tissue ◽

The Right

Ectopic thyroid tissue is seen rarely. It is often seen in cervical midline, and rarely in other areas such as submandibular area. Diagnosis is made histopathologically by fine needle biopsy after the elimination of malignancy. In the treatment of ectopic thyroid tissue, surgical excision is mostly applied. According to our knowledge, there is no exophytic thyroid tissue reported in the literature. In this paper, a 32-year-old woman who presented with a swelling under the right jaw and found a thyroid tissue attached to the normally located thyroid gland with a fibrous band in the neck was discussed.

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The Scintigraphic Visualization of a Lingual Thyroid After Excision of Associated Ectopic Thyroid Tissue

Clinical Nuclear Medicine ◽

10.1097/00003072-197907000-00002 ◽

1979 ◽

Vol 4 (7) ◽

pp. 275-276 ◽

Cited By ~ 4

Author(s):

SYDNEY HEYMAN

Keyword(s):

Thyroid Tissue ◽

Ectopic Thyroid ◽

Lingual Thyroid ◽

Ectopic Thyroid Tissue

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Incidental Finding of Dual Ectopic Thyroid on Computed Tomography Angiography

Journal of Clinical Imaging Science ◽

10.4103/jcis.jcis_21_17 ◽

2017 ◽

Vol 7 ◽

pp. 30 ◽

Cited By ~ 1

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.

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Lingual thyroid gland: it’s time for awareness

Endocrinology Diabetes and Metabolism Case Reports ◽

10.1530/edm-20-0026 ◽

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.

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