Lingual thyroid with absent thyroid gland in neck

<p class="abstract">Lingual thyroid is defined as an ectopic thyroid gland tissue located in the midline of the tongue base. Patients with lingual thyroid tissue usually present with symptoms such as dysphagia, choking, haemorrhage, dyspnea and occasionally life threatening airway obstruction. Lingual thyroid is a rare anomaly with an incidence of 1 in 3000 of the thyroid cases seen, with overall prevalence of 1 in 100,000. Here we presented a case with complaint of difficulty in swallowing and foreign body sensation throat. The intraoral examination showed spherical mass with 2 cm of diameter, covered with intact mucosa, located midline at base of tongue. She was diagnosed clinically as lingual thyroid and evaluated further. By proper transdisciplinary approach correct diagnosis can be made and patient can be managed. In present case, thyroid profile, USG neck and thyroid scintigraphy helped in diagnosis. Patient was managed medically with tablet levothyroxine which relieved her symptoms. Surgical management was not considered as patient improved with levothyroxine and surgical excision would have made patient further hypothyroid as there was no thyroid gland in neck.</p>

Thyroid Hemiagenesis Accompanying an Ectopic Lingual Thyroid

Lingual thyroid is an uncommon condition and cases accompanying thyroid hemiagenesis are rarely documented. Patients with thyroid hemiagenesis are usually asymptomatic and generally diagnosed incidentally. Herein, we reported the case of thyroid hemiagenesis accompanying an ectopic lingual thyroid with euthyroidism and presented with regional symptoms.

Transoral robotic resection of a lingual thyroid: a novel treatment for obstructive sleep apnoea

A 34-year-old woman with a history of congenital hypothyroidism and 15 years of obstructive sleep apnoea was admitted with a left submandibular swelling secondary to a dental infection. A CT scan of the neck identified an incidental 27 mm tongue base mass and the absence of any cervical thyroid tissue. This mass was not observable on examination of the oropharynx but was seen on fine nasendoscopy while thyroid function tests showed good thyroid stimulating hormone suppression. Her acute dental infection was treated and, following multidisciplinary team discussion, she was diagnosed with an ectopic lingual thyroid. She was offered different management options including no intervention and radio-iodide treatment but opted for transoral robotic resection. The lesion was resected en bloc with clear margins and histology confirmed lingual thyroid tissue. Since the procedure, she has remained free of sleep apnoea with a significantly improved quality of life.

Submandibular ectopic thyroid gland: an uncommon presentation

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.

Lingual thyroid: An incidental cytological finding

Lingual thyroid (LT) is a developmental defect due to the failure of the thyroid gland to descend to its normal cervical location during embryogenesis. Lingual thyroid has an overall prevalence of 1 in 100,000 to 1in 3,00,000 and is seven to ten times more common in females than in males .Lingual position represents the most frequent ectopic location accounting up to 90% of ectopic cases. It is found at the junction of the anterior two thirds and the posterior third, between the epiglottis and the circumvallate papillae. Most cases are asymptomatic, however, increase in size can cause local symptoms like upper airway obstruction, dysphagia and hemorrhage at any time from infancy to adulthood. Thyroid scintigraphy, neck ultrasound, CT- scan, MRI are some diagnostic modalities that play a vital role in diagnosing ectopic thyroid gland. Treatment of this anomaly includes exogenous L-thyroxine hormone administration, radioiodine ablation therapy and surgery. We hereby report a rare case of lingual thyroid in a young girl reported by fine needle aspiration cytology.

Is Transoral Robotic Surgery the Best Surgical Treatment for Lingual Thyroid?: A Case-Report and Literature Review

Objectives: To highlight the specific outcomes of the current surgical procedures for lingual thyroid excision, for benign and malignant lesions. Methods: We carried out a systematic review of surgical treatments of lingual thyroid, according to the PRISMA method. We conducted our literature search in PubMed and Ovid. Data was collected concerning patient demographics, tumor characteristics, types of surgery performed, and specific intra- and postoperative outcomes of each procedure. Surgical procedures were classified in 4 categories: transcervical approaches, “invasive” transoral approaches (transmandibular and/or tongue splitting), “non-invasive” transoral approaches, and transoral robotic surgery. We detailed the transoral robotic surgical technique through a case report, along with a surgical video. Results: Of 373 peer-reviewed articles found, 40 provided adequate information on surgical management and outcomes for patients with lingual thyroid. “Non-invasive” transoral approaches and transoral robotic surgeries required significantly fewer tracheostomies than “invasive” transoral and transcervical approaches ( P < .001), while there was no statistical difference in the rate of surgical complications between each procedure. Conclusions: Transoral robotic surgery appears to be a feasible, effective, and fast solution for lingual thyroid excision, with excellent short- and long-term surgical outcomes.