Primary accessory thyroid carcinoma with negative 99mTcO4− SPECT/CTimaging: a case report and literature review

Introduction In contrast to orthotopic thyroid carcinoma, primary accessory thyroid carcinoma is very rare. We herein report a case involving primary accessory thyroid carcinoma in a patient with normal ultrasonography of the orthotopic thyroid and negative 99mTcO4− single-photon emission computed tomography (SPECT) scintigraphy. Case presentation: A computed tomography (CT) scan showed soft tissue nodules at the left anterior edge of the thyroid cartilage. To determine whether the mass was accessory thyroid tissue, 99mTcO4− SPECT/CT was performed, and the findings were negative. However, pathological examination after resection showed that mass was a primary accessory thyroid papillary carcinoma. The 1-year follow-up ultrasound showed no lesion at the orthotropic thyroid and neck incision sites. Conclusions This case suggests that negative 99mTcO4− SPECT/CT imaging may not completely exclude the possibility of thyroid carcinoma. A punch biopsy or postoperative pathological examination is necessary for the diagnosis.

ACCESSORY THYROID GLAND WITH DUAL BLOOD SUPPLY: A RARE VARIATION

A rare congenital anomaly of thyroid gland due to developmental defect is accessory or ectopic thyroid gland. Ectopic thyroid refers to the presence of thyroid tissue in locations other than the normal in anterior neck region between the second and fourth tracheal cartilages. Abnormal organogenesis of the thyroid gland leads to morphological variations, such as thyroid dysgenesis, hypoplasia, hemiagenesis and agenesis. The ectopic or accessory thyroid being the most common form of thyroid dysgenesis. Here, we are presenting a case with the accessory thyroid tissue with dual blood supply observed during a routine dissection of a female cadaveric body. The accessory thyroid tissue was in the form of an oval structure about 1.5cm x 3 cm was situated in the midline 2cm above the normally located thyroid gland which was supplied by a branch of lingual artery as well as superior thyroid artery. The accessory thyroid tissue could be asymptomatic or it could present with any disorder affecting the main thyroid gland including malignancy. The significance of this case is to show an anatomical variation in the form of developmental defect during the organogenesis of thyroid along with its clinical implications. Thus, this report highlights the importance of knowing and understanding the normal anatomy of thyroid as well as the anatomical variant that could be immensely beneficial while diagnosing thyroid disorders or carrying out surgical procedures involving thyroid.

Lingual Thyroid: A rare case report

Lingual Thyroid is rare developmental anomaly usually affecting females it is usually located in midline, in base of the tongue and represent the faulty migration of thyroid gland although the exact pathogenesis of this ectopic accessory thyroid tissue is not known it generally originates from the epithelial tissue of non obliterated thyroglossal ductus in this report a case of lingual thyroid in a 28 year old patient with difficulty in swallowing and foreign body sensation complaints for 3 years is presented ultrasound showed absent Thyroid in Neck. DOI: http://dx.doi.org/10.3126/jcmsn.v7i3.6708 Journal of College of Medical Sciences-Nepal, 2011, Vol-7, No-3, 39-42

Accessory Thyroid Gland In A Patient with Hypothyroid State

A 40 yrs female muslim housewife attended Endocrinology department of Dhaka Medical College Hospital with the complaints of swelling in front of neck, alone with dryness of the skin, cold intolerance, constipation and menorrhagia. Physical examination and laboratory investigations substantiated the diagnosis of accessory thyroid gland in front of neck above the isthmus of the thyroid gland. RAIU and scanning showed normally present thyroid gland with accessory thyroidal nodular swelling in the midline in the upper part of front of neck .USG of the thyroid gland showed normal size of thyroid gland with coarse echo texture. A hypo echoic solid thyroid nodule was also seen above the isthmus of the thyroid gland, measuring about 2.4 cm×2.2cm. Thyroid function tests revealed hypothyroidism. She is on thyroid hormone replacement therapy. This rare presentation of accessory thyroid gland with hypothyroid state led us to report the case. Keywords: Accessory thyroid gland, Hypothyroidsm, Ectopic, Bangladesh DOI: http://dx.doi.org/10.3329/jom.v12i2.8426 JOM 2011; 12(2): 180-182