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Lingual thyroid and hypothyroidism – Lingual thyroid

The patient is now on a regular follow-up.

Matthew Cox
Saturday, October 24, 2020
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  • FIL was performed, remarkable for an inflamed and vascular mass at the base of the tongue highly suspicious for ectopic thyroid tissue Figs 1 and 2. Microscopic histologic description.

  • Examination of the oral cavity to look for the nodule in the base of the tongue and palpation of the neck to assess the thyroid gland in orthotopic location is an essential initial evaluation [ 711 ]. Int J Surg Case Rep.

  • In our patient, I thyroid scan showed a nondescended thyroid tissue in the base of the tongue.

  • Surgical removal of the only functioning thyroid tissue needs lifelong hormone replacement therapy [ 812 ]. Shenoy, P.

Publication types

The thyroid gland is normally located in the pretracheal region of the anterior neck inferior to the thyroid cartilage at the level of the C5-T1 vertebra [ 1 ]. Metrics details. Download other formats More.

Good knowledge of embryogenesis will result in proper diagnosis. Currently, she has regular follow-ups with the endocrinologists and remains euthyroid. Lingual thyroid for publication Verbal consent was obtained from the patient for publication of this case report and accompanying images. Arrest of thyroid embryogenesis at any stage of descent gives rise to multiple anomalies including ectopic thyroid [ 3 ]. The majority of patients with thyroid ectopy are asymptomatic, but obstructive symptoms as well as hypothyroidism have been observed. We decided to manage the lingual thyroid conservatively and she was started on substitutive hormone therapy. Computed tomography CT scan of the neck.

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Frequently, lingual thyroid and hypothyroidism these patients, lingual thyroid is detected hypothyroifism the diagnostic investigation of subclinical hypothyroidism. This tract degenerates as the thyroid reaches its final position at the level of hyoid bone. View at: Publisher Site Google Scholar. Ramanathan, J. This confirmed the diagnosis of a coexisting lingual thyroid. But subsequent investigations revealed clinical hypothyroidism.

Torres-Torres et al. We suspected the presence of a submental abscess; accordingly, the patient was referred for head and neck contrast computed hypothygoidism CT. Treatment consisted in restoration of a euthyroid state with thionamide followed by surgical removal of the ectopic gland. Lingual thyroid is a rare clinical entity that presents as a nodule in the base of the tongue. View at: Publisher Site Google Scholar.

Currently, she has regular follow-ups with the endocrinologists and remains euthyroid. Received 04 Oct Rivera-Santana, M. Shakrawal, A.

Quiz questions

Patients with subclinical hypothyroidism with symptoms or overt hypothyroidism are managed conservatively with exogenous thyroid hormone supplement to suppress and reduce the size of the ETT resolving the symptoms [ 4 — 11 ], as in our case. Ablative radioiodine therapy is considered in patients unfit for surgery or refusing intervention [ 4 — 9 ]. Export References. Sherin A. Not registered?

The images hhypothyroidism other third party material in this article are included in the article's Creative Commons licence, unless indicated lingual thyroid in a credit line to the material. Furthermore, she was started on intravenous antibiotics. As in our case, thyroid was absent in a normal location. Based on the clinical examination, thyroid function test report, USG, and CT findings, a definitive diagnosis of lingual thyroid with subclinical hypothyroidism was made, and the patient was planned for conservative pharmacological management with levothyroxine supplement. ETT may be also found in the cardiac muscle, ascending aorta, thymus, esophagus, duodenum, gall bladder, stomach bed, pancreas, mesentery of the small intestine, porta hepatis, adrenal gland, ovary strumaovariifallopian tube, uterus, and vagina [ 23 ].

Lingual thyroid; a report of a case with unusual histology. Case Report Type. Often no treatment is required. We observed no ajd in the TSH after four months, showed in Table 1. Hence, careful evaluation using adequate diagnostic techniques and appropriate treatment modalities become important as a mere misinterpretation from part of the surgeon may lead to lifelong misery and discomfort to the patient. The treatment with LT4 could result in partial involution of lingual thyroid volume.

Hence, careful evaluation using adequate diagnostic techniques and appropriate treatment modalities become important as a mere misinterpretation from part of and hypothyroidism surgeon may lead to lifelong misery and discomfort to the patient. Increased demand for thyroxine during puberty and pregnancy increases the work of the only functional ectopic tissue and, hence, increases LT size [ 26811 ]. Subsequently, the full text was reviewed to judge whether the articles met the pre-determined inclusion criteria. Thyroid function tests showed normal FT3: 3. More related articles. Obstructive lingual thyroid causing sleep apnea: A case report and review of the literature. Ultrasound is only of use in demonstrating absent thyroid tissue in the normal location, which is the case in the majority of cases 1.

Key messages

Sagittal view of contrast-enhanced CT showing lingual thyroid: a well-defined, rounded, mainly hyper-dense soft tissue density at the base of the tongue blue arrow ; submental abscess yellow arrow. Received : 09 April Patients with the only functional lingual thyroid tissue LT can be excised and autotransplanted in the muscles of the neck [ 3 — 6 ]. The thyroid gland is the first endocrine gland to develop beginning around 20—24 days of gestation [ 1 ] from the endoderm of the first and second pharyngeal pouch.

Ninety percent of thyroid ectopia involves the lingual region [ 1 ]. Patients should be monitored through follow-ups for the development of complications hypothyroidism dysphagia or dyspnea or, in very rare circumstances, carcinoma. She had no other systemic complaints. Download references. Fine-needle aspiration cytology FNAC helps to confirm the ectopic thyroid tissue and to rule out malignancy [ 2 — 411 ]. This tract degenerates as the thyroid reaches its final position at the level of hyoid bone.

Nair, A. Abstract Thyroid tissue presenting as a nodule in the base of the tongue due to the embryonic failure to hypothyroidixm to the anterior neck is a rare clinical entity, called lingual thyroid. Case presentation We present a year-old lady who presented with sub-mental abscess. We report a case of a year-old female who presented with a foreign body sensation in the throat with mild dysphagia for 3 weeks.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Surgical removal of the only functioning thyroid tissue needs lifelong hormone replacement therapy [ 812 ]. The thyroid gland starts to develop at the 3rd week of gestation; development by descent along the thyroglossal tract to the final pre-laryngeal position is completed at the 7th week. Clinical presentation varies depending upon the degree of obstruction caused by an enlarged nodule or features related to thyroid function. Conclusions Lingual thyroid is a rare clinical entity. Int J Surg Case Rep.

INTRODUCTION

Benign or malignant neoplastic changes were sometimes described in ectopic thyroid tissue [ 11 ]. Lingual thyroid as a cause of snoring and sleep apnea. Surgical excision is indicated in symptomatic patients not responding to conservative management and patients with severe respiratory tract obstruction, bleeding, ulceration, and malignancy [ 3 — 10 ].

Lingual thyroid and hypothyroidism diagnostic workup including clinical examination, biochemical profile, imaging tools, radioisotope scanning, and histopathology is necessary to plan the management in lingual thyroid [ 7810 ]. The prevalence of lingual thyroid ranges from 1 into ,; the prevalence is approximately 4 to 8 times higher in females than in males [ 2 ]. Correspondence to Tahera Islam. Reported lingual thyroid is more among patients with thyroid disease [ 3 ]. Verma, and D.

No thyroid gland was seen in the orthotopic location Figure 2. Depending on the size of the mass, some patients may present with more severe symptoms such as dysphagia, dysphonia, dyspnea, and hemorrhage [ 2 ]. Torres-Torres et al. Amr and S.

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Nair, A. Ethics declarations Ethics approval and consent to participate Not applicable. Kamath, and A.

Farrell ML, Forer M. Scintigraphy interpretation. Thyroid ultrasonography. Surgical removal of the only functioning thyroid tissue needs lifelong hormone replacement therapy [ 812 ]. Conn Med.

The patient was diagnosed as lingual thyroid with subclinical hypothyroidism based on clinical findings, imaging, and fine-needle aspiration cytology. View at: Google Scholar D. Int J Surg. Acknowledgements Not applicable. Published 30 Jan She was started on substitutive hormone therapy and remains asymptomatic.

Sagittal lingual thyroid and hypothyroidism of contrast-enhanced CT showing lingual thyroid: a well-defined, rounded, mainly hyper-dense soft tissue density at the lingua, of the tongue blue arrow ; submental abscess yellow arrow. Accepted : 20 May Color Doppler can aid to demonstrate the vascularity of the nodule. Thyroid tissue presenting as a nodule in the base of the tongue due to the embryonic failure to descend to the anterior neck is a rare clinical entity, called lingual thyroid. We suspected the presence of a submental abscess; accordingly, the patient was referred for head and neck contrast computed tomography CT. A contrast-enhanced CT study is helpful to characterize the pattern of enhancement. A CT scan was performed to confirm the diagnosis.

Case Reports in Endocrinology

Thyroid scintigraphy. The suppressive drug therapy based on suppressive dose of Levothyroxine depends on the ectopic gland size. Clinical images.

Currently, she has regular follow-ups with the endocrinologists and remains euthyroid. Hoilat, J. Lingual thyroid is a rare embryological aberration resulting from the arrest of downward migration of the thyroid gland. Download references. Background Lingual thyroid is a rare embryological aberration resulting from the arrest of downward migration of the thyroid gland.

Clinically lingual thyroid may manifest with symptoms such as dysphagia, dysphonia, or even bleeding, hypothyroicism upper respiratory tract obstruction. Neck and thyroid ultrasound were distinctive for absent thyroid tissue at the expected anatomic position. Yang and K. Discussion As mentioned, LT is an uncommon entity. Download PDF. Aluffi, and F. Congenital tumour of the base of the tongue passing down the epiglottis on the larynx and causing death by suffocation sixteen hours after death sic.

Case Rep Pediatr. Case Report A thyroie female presented to the outpatient department with a history of foreign body sensation in the throat with mild dysphagia for 3 weeks. Majority of patients are asymptomatic and are diagnosed incidentally through head and neck radiography. Verbal consent was obtained from the patient for publication of this case report and accompanying images.

Thyroid function tests are used to evaluate the functional status of the thyroid gland. Related articles. No thyroid gland was seen in the orthotopic location Figure 2. This explains why the reported lingual thyroid is common among females. Figure 2.

The case kim hastreiter new york diet shakes a subclinical hypothyroidism that receives treatment of regularization of TSH levels with Levothyroxine Sodium successfully. The patient was referred to Endocrinology clinics for further evaluation. View raw image FIL showing evidence of an inflamed and vascular ectopic thyroid tissue at the base of the tongue. Combining this main set with a second set of articles identified relevant studies.

Fine-needle aspiration cytology FNAC helps to confirm the ectopic thyroid tissue and to rule out malignancy abd 2 — 411 ]. High-resolution ultrasonography USG is a readily available and noninvasive tool in the evaluation of the thyroid gland in the orthotopic location and detection of the ectopic thyroid nodule [ 6 ]. Throat examination showing midline nodule in the base of the tongue. Figure 2. Hormone replacement therapy with thyroxine should be started in apparently asymptomatic patients, when there is evidence of hypothyroidism.

Meticulous hypothyrkidism workup including clinical examination, biochemical profile, imaging tools, radioisotope scanning, and histopathology is necessary to plan the management in lingual thyroid [ 7lingual thyroid and hypothyroidism10 ]. Published 30 Jan Taskaldiran, S. Patients with subclinical hypothyroidism with symptoms or overt hypothyroidism are managed conservatively with exogenous thyroid hormone supplement to suppress and reduce the size of the ETT resolving the symptoms [ 4 — 11 ], as in our case. Thyroid function tests are warranted whenever lingual thyroid is diagnosed irrespective of clinical presentation. Kaushal, N. A contrast-enhanced CT study is helpful to characterize the pattern of enhancement.

Verma, and D. In case of hypothyroidism, like in our patient, thyroid replacement therapy lingual thyroid and hypothyroidism initiated, which further aims to simultaneously shrink the ectopic tissue [ 4 ]. The majority of patients with thyroid ectopy are asymptomatic, but obstructive symptoms as well as hypothyroidism have been observed. Academic Editor: Osamu Isozaki.

Ibrahim and I. View at: Google Scholar T. CT demonstrates a hyperdense soft tissue mass, of the same attenuation as normal thyroid tissue. Click here for information on linking to our website or using our content or images.

Thyroid function tests are either normal majority of patients hypothyroidiism demonstrate variable states of hypothyroidism up to a third of patients 2. Amr and S. The effectiveness of treatment to eliminate the symptoms and the length of treatment before moving on to another treatment modality is also unknown. Sherin A. A CT scan can also be helpful to detect possible nodules in mediastinum [ 2 ].

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Exposed tumor. De Falco et al. Lappas, and K. The authors performed the search independently. The clinical presentation of lingual thyroid could be classified into two groups according to the appearance of the symptoms. Akyol MU, Ozcan M.

Whereas mutations in the transcription hypothyrooidism TTF-2 and PAX8 and in the TSH receptor genes TSH-R have been reported in a minority of patients with thyroid dysgenesis, the etiopathogeny of the majority of cases, and in particular of thyroid ectopy, remains unclear. The patient is now on a regular follow-up. Head and neck contrast-enhanced axial computed tomographic scan showing a hyperdense soft tissue density in the midline at the base of the tongue arrow. A CT scan was performed to confirm the diagnosis.

More related articles. Currently, she has regular follow-ups with the endocrinologists and remains euthyroid. The CT scan confirmed submental abcess and incidentally discovered lingual thyroid along with absence of thyroid tissue in its normal pretracheal position. Verma, and D. De Falco et al.

The patient is now on a regular follow-up. Shakrawal, A. Investigation TSH of 6. Physical examination showed a mass at the base of the tongue and no palpable thyroid tissue at the anterior neck. ETT may be also found in the cardiac muscle, ascending aorta, thymus, esophagus, duodenum, gall bladder, stomach bed, pancreas, mesentery of the small intestine, porta hepatis, adrenal gland, ovary strumaovariifallopian tube, uterus, and vagina [ 23 ].

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Lingual thyroid and hypothyroidism four months a new TSH evaluation was performed and showed normal range. Thyorid removal of the only functioning thyroid tissue needs lifelong hormone replacement therapy [ 812 ]. A total of 80 patients received medical management for their symptoms, while 2 patients were asymptomatic when they received treatment. J Otolaryngol. Where information on age was available, the ages ranged from 3months to 83years. Article information. Withdrawal Guidlines.

The resultant dataset was limited to studies in humans and those published in the English language. The diagnosis of such a rare entity is and hypothyroidism easy, while the treatment may still be challenging. Ann Maxillofac Surg. Absence of uptake in the thyroid bed anterior neck with probable location at the base of the tongue, suggestive of ectopic thyroid. Midline of base of tongue, usually between circumvallate papillae and epiglottis Dome shaped, soft to firm mass with smooth surface, rarely ulcerated Several mm to several cm in size mean 2 - 3 cm Red, smooth to lobulated to nodular, either well or ill defined on sectioning. Follicular carcinoma with clear cell change arising in lingual thyroid.

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Lingual thyroid: A comprehensive review. Postoperative period was uneventful; speech improved and dysphagia was considerably reduced. A CT scan can also be helpful to detect possible nodules in mediastinum [ 2 ]. J Oral Maxillofac Surg. Studies published prior to and after

Lingual thyroid is the result of a defective migration of the thyroid anlage occurring between the 3rd and 7th week of gestation. Ninety percent of thyroid ectopia involves the lingual region [ 1 ]. But subsequent investigations revealed clinical hypothyroidism. Rao, V. In some cases, lifelong hormone replacement may be needed. Full size image.

Lingual thyroid is a very rare pathological finding and is usually incidentally discovered. Management of the lingual thyroid depends upon the severity of clinical symptoms and complications. A CT scan can also be helpful to detect possible nodules in mediastinum [ 2 ]. Int J Surg. All authors have read and approved the manuscript. Furthermore, she was started on intravenous antibiotics. Along with these observations, the contrast CT failed to visualize normal thyroid density in the pre-tracheal area.

Failure to descend to the normal anatomical position results in the ectopic location of the thyroid tissue. Int J Surg. The presence of thyroid tissue outside its normal anatomical position due to embryonic failure to descend is called ectopic thyroid tissue ETTand when present at the base of the tongue, it is called lingual thyroid LT.

Well defined mass. Studies have determined that clinical manifestations peak ,ingual a mean age of 40 years 1 as is seen in our case. Direct examination may reveal a nodular red mass of variable size, ranging from a few millimeters to cm 2. Citation: Aleid H, Alharbi A. Baughman RA. Figure 9.

Lingual thyroid is lingual thyroid and hypothyroidism rare clinical entity of the oropharyngeal region annd by failure in descendence of thyroid gland to its normal position during embryogenesis. Close View raw image FIL showing evidence of an inflamed and vascular ectopic thyroid tissue at the base of the tongue. Not registered? External carotid artery angiogram. Two-hundred twenty-eight titles of articles were reviewed. In addition, malignant transformation of the lingual thyroid has been reported, albeit rarely [ 4 ].

  • Endocrine Reviews 25 —

  • Thyroid function tests are warranted whenever lingual thyroid is diagnosed irrespective of clinical presentation.

  • The osteotomized mandible was repositioned and plated [ Figure 6 ] and primary closure was achieved [ Figure 7 ].

  • Reported histotypes are papillary, follicular, mixed follicular and papillary, Hurthel cell, and medullary [ 23 ]. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Surgical excision is indicated in symptomatic patients lingual thyroid and responding to conservative management and patients with severe respiratory tract obstruction, bleeding, ulceration, and malignancy [ 3 — 10 ]. J Thyroid Res. Ethics declarations Ethics approval and consent to participate Hypothyroivism applicable. She was started on substitutive hormone therapy and remains asymptomatic. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Lingual thyroid is a rare clinical entity. Discussion The thyroid gland starts to develop at the 3rd week of gestation; development by descent along the thyroglossal tract to the final pre-laryngeal position is completed at the 7th week.

Article of the Year Award: Outstanding research contributions ofas selected by our Chief Editors. Verbal consent was obtained from the patient for publication of this case report and accompanying images. Thyroid function tests are warranted whenever lingual thyroid is diagnosed irrespective of clinical presentation. Verma, and D. This tract degenerates as the thyroid reaches its final position at the level of hyoid bone.

The commonest location of the ectopic thyroid tissue Hypothyroidism in the head and neck region is the lingual [ 1 ] and sublingual location followed by the trachea, submandibular gland, lateral cervical region, maxilla, palatine tonsils, carotid bifurcation, iris of the eye, and pituitary gland. Amr and S. A contrast-enhanced CT study is helpful to characterize the pattern of enhancement.

  • Ectopic thyroid. With ectopic thyroid tissue, specifically a lingual thyroid, the protocol for treatment, including the dose, time and length of treatment, is unclear in the literature.

  • This tract degenerates as the thyroid reaches its final position at the level of hyoid bone. Lingual thyroid constitutes the majority of ectopic thyroid cases; however, remnants of thyroid tissue have been documented in different positions along the migration tract [ 4 ].

  • From the clinical and imaging findings the diagnostic of ectopic thyroid and subclinical hypothyroidism were reached. Asymptomatic euthyroid patients need regular follow-up [ 310 ].

  • Computed tomography CT and magnetic resonance imaging MRI are valuable tools to define the location of the mass, presence of calcification, relation to the surrounding structure, and degree of luminal obstruction. Lingual thyroid; a report of a case with unusual histology.

The patient was diagnosed as lingual thyroid with subclinical diet shakes based on clinical findings, imaging, and fine-needle aspiration cytology. In case of hypothyroidism, like in our patient, thyroid replacement therapy is initiated, which further aims to simultaneously shrink the ectopic tissue [ 4 ]. We present a year-old lady who presented with sub-mental abscess. The patient was admitted, and aspiration of the fluid collection was performed. There was no significant medical or surgical history in the past. Throat examination revealed a well-defined nodule in the midline at the base of the tongue with intact smooth mucosa Figure 1. Correspondence to Tahera Islam.

Hypohyroidism cases of LT are asymptomatic [ 4 — 9 ] unless an increase in gland size occurs resulting in dysphagia, dysphonia, foreign body sensation in the throat, cough, pain, bleeding, and dyspnea [ 2 ]. About this article. Download citation. Patients may remain asymptomatic and are diagnosed incidentally even though there is biochemical evidence of hypothyroidism.

Case Rep Pediatr. Abstract Background Lingual thyroid is a very rare pathological finding and is usually incidentally discovered. Herein, we describe an unusual case of thyrotoxicosis related to a nodular lesion in a lingual thyroid. Majority of patients are asymptomatic and are diagnosed incidentally through head and neck radiography. Kaushal, N. Majority of patients are asymptomatic. Radiol Case Rep.

Case Reports in Endocrinology

Majority of patients are asymptomatic and are diagnosed incidentally through head and neck radiography. Journal overview. Abbreviations CT: Computed tomography.

  • Subsequently, the full text was reviewed to judge whether the articles met the pre-determined inclusion criteria.

  • The estimated prevalence of reported ectopic thyroid is 1 per ,—, healthy individuals [ 2 — 5 ], which is even more high among the patients with thyroid disease 1 per to cases [ 3 ].

  • There have been reports of patients with LT that present with complications of respiratory tract obstruction and obstructive sleep apnea OSA 17. This conservative management led to ectopic tissue size reduction, as well as the complete resolution of symptoms.

  • Guerra, M. Abstract Lingual thyroid gland is a rare clinical entity.

MRI is useful in estimating extent of a lesion, because it can lingual thyroid and hypothyroidism distinguish thyroid tissue low-intermediate T2 signal from the tongue muscle Hormones Athens ; Abstract Thyroid tissue presenting as a nodule in the base of the tongue due to the embryonic failure to descend to the anterior neck is a rare clinical entity, called lingual thyroid. Prognosis is good, since resection of lingual thyroid achieves significant improvement in patient symptoms with low rates of recurrence Wenig: Atlas of Head and Neck Pathology, 3rd Edition, Amr and S.

Studies have determined that clinical manifestations peak at a lingual thyroid and hypothyroidism age of 40 years 1 as is seen in our case. Received: February 07, Published: April 15, The patient remains with thyroid hormone tests in normal range, and there are clinical improvement of the symptoms of dysphagia and foreign body sensation in the throat. Mussak and A. The development of acute local symptoms in ectopic thyroid is dependent on the size of the gland and the presence of other acute processes, such as bleeding.

Springer Nature remains neutral linhual regard to jurisdictional lingual thyroid and hypothyroidism in published maps and institutional affiliations. To our knowledge, only 2 cases have been reported in the literature to date. Throat examination revealed a well-defined nodule in the midline at the base of the tongue with intact smooth mucosa Figure 1. Santangelo, G. Published 30 Jan Along with these observations, the contrast CT failed to visualize normal thyroid density in the pre-tracheal area.

Treatment Upon thyrkid Endocrinology clinic evaluation, the patient was diagnosed with subclinical hypothyroidism not requiring total hormone replacement therapy THRT. Congenital tumour of the base of the lingual thyroid and hypothyroidism passing down the epiglottis on the larynx and causing death by suffocation sixteen hours after death sic. Site of occurrence of this aberrant tissue may be used as a prefix, as in lingual thyroid. Method: Applying established methodology, we conducted a systematic review of the literature on the management of lingual thyroid from to December

Clinical presentation varies and hypothyroidism upon the degree of obstruction caused by an enlarged nodule or features related to thyroid function. Treatment consisted in restoration of a euthyroid state with thionamide followed by surgical removal of the ectopic gland. Lingual thyroid constitutes the majority of ectopic thyroid cases; however, remnants of thyroid tissue have been documented in different positions along the migration tract [ 4 ]. Shenoy, P. A CT scan can also be helpful to detect possible nodules in mediastinum [ 2 ]. Funding None. Published : 26 August

  • The commonest location of the ectopic thyroid tissue ETT in the head and neck region is the lingual [ 1 ] and sublingual location followed by the trachea, submandibular gland, lateral cervical region, maxilla, palatine tonsils, carotid bifurcation, iris of the eye, and pituitary gland.

  • Hormone replacement therapy with thyroxine should be started in apparently asymptomatic patients, when there is evidence of hypothyroidism. Download other formats More.

  • Figure 3. Otolaryngol Clin North Am.

Amr B, Monib S Lingual thyroid: a case report. The CT scan confirmed submental abcess and incidentally discovered lingual thyroid along with absence of thyroid tissue in its normal pretracheal position. Ibrahim and I. The patient was admitted, and aspiration of the fluid collection was performed. Urgent intervention is required for patients presenting with dysphagia, dysphonia, dyspnea, or hemorrhage.

Competing interests The authors hypothyoridism that they have no competing interests. These lingual thyroid and hypothyroidism findings were suggestive of ectopic thyroid at the tongue base, as shown in Figs. Reprints and Permissions. We report a case of a year-old female who presented with a foreign body sensation in the throat with mild dysphagia for 3 weeks. Conclusions Lingual thyroid is a rare clinical entity.

ETT may be also found in the cardiac muscle, ascending aorta, thymus, esophagus, duodenum, gall bladder, stomach bed, pancreas, mesentery of the small intestine, porta hepatis, adrenal gland, ovary strumaovariifallopian tube, uterus, and vagina [ 23 ]. Conclusion Lingual thyroid patients may remain asymptomatic with subclinical hypothyroidism. She was referred to an endocrinologist for her hypothyroidism. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Axial noncontrast CT image with a well-defined relatively hyperdense nodule in the midline at the base of the tongue aaxial contrast-enhanced CT showing homogeneous enhancement bsagittal contrast-enhanced CT image with an enhancing nodule at the level of C2-C3 vertebra causing narrowing of the oropharyngeal lumen caxial contrast-enhanced CT image below the cricoid cartilage without orthotopic thyroid dcoronal maximum intensity projection MIP image with a nodule in the midline e with absent orthotopic thyroid, and volume rendered image with a nodule in the midline f.

  • Endocrine Reviews 25 — The majority of cases are asymptomatic and when symptoms occur these are often determined by mass size.

  • Conclusion Lingual thyroid patients may remain asymptomatic with subclinical hypothyroidism. Key messages Patients with hypothyroidism due to ectopic thyroid may remain symptom free and only come to attention after thyroid function test are carried out.

  • Download other formats More. S3—S11,

Four months later a new evaluation was performed and there were no changes in the Thyroif levels. Hypothyroidism factors. Investigation should include thyroid function tests. Chest X-ray was normal. There is no consensus in the literature for the correct management of lingual thyroid. The resulting locations are designated as lingual, sublingual, pretracheal normal and substernal. In this case report the diagnostic was obtained with aid of thyroid scintigraphy, ultrasound, and laryngoscopy.

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LT lkngual first noticed by Hickmann in [ 58 — 10 ]. Axial noncontrast CT image with a well-defined relatively hyperdense nodule in the midline at the base of the tongue aaxial contrast-enhanced CT showing homogeneous enhancement bsagittal contrast-enhanced CT image with an enhancing nodule at the level of C2-C3 vertebra causing narrowing of the oropharyngeal lumen caxial contrast-enhanced CT image below the cricoid cartilage without orthotopic thyroid dcoronal maximum intensity projection MIP image with a nodule in the midline e with absent orthotopic thyroid, and volume rendered image with a nodule in the midline f. Souza Castro, L. Ibrahim and I. Download PDF.

Surgical removal of the only functioning andd tissue needs lifelong hormone replacement lingual thyroid and hypothyroidism [ 812 ]. The thyroid gland is normally located in the pretracheal region of the anterior neck inferior to the thyroid cartilage at the level of the C5-T1 vertebra [ 1 ]. About this article. The patient denied any symptoms of hypothyroidism. Throat examination revealed a well-defined nodule in the midline at the base of the tongue with intact smooth mucosa Figure 1.

Case Reports in Otolaryngology

Images hosted on other servers: Lingual thyroid with follicular carcinoma. Article of the Year Award: Outstanding research contributions ofas selected by our Chief Editors. Clinical characteristics of ectopic thyroid in Korea.

Ibrahim and I. There was no significant medical or surgical history in the past. Published 30 Jan Taskaldiran, S. Surprisingly, some presented with hyperthyroidism [ 6 ].

Our systematic review found similar high rates Quiz questions. Lingual thyroid: Value of integrated imaging. Studies have determined that gene transcription factors NKX, FOXE1, and PAX-8 are crucial for thyroid morphogenesis and differentiation for which it is presumed that mutation in these genes leads to abnormal thyroid migration 12.

During its migration, the thyroid gland is attached to the base of the tongue by the thyroglossal duct which solidifies and gradually degenerates by the 10 th week of gestation [ 1 ]. Accepted 19 Jan Consent for publication Verbal consent was obtained from the patient for publication of this case report and accompanying images. Here, we report a woman who presented with submental abscess confirmed on CT scan, along with an incidental diagnosis of with lingual thyroid. Acknowledgements Not applicable.

Acknowledgements Not applicable. Reported histotypes are papillary, follicular, mixed follicular and papillary, Hurthel cell, and medullary [ 23 ]. Patients may remain asymptomatic and are diagnosed incidentally even though there is biochemical evidence of hypothyroidism. The thyroid gland could not be appreciated on neck palpation.

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Urgent intervention is required for patients presenting with dysphagia, dysphonia, dyspnea, or hemorrhage. Reported lingual thyroid lingual thyroid and hypothyroidism more among patients with thyroid disease [ 3 ]. The commonest location of the ectopic thyroid tissue ETT in the head and neck region is the lingual [ 1 ] and sublingual location followed by the trachea, submandibular gland, lateral cervical region, maxilla, palatine tonsils, carotid bifurcation, iris of the eye, and pituitary gland. Background Lingual thyroid is a rare embryological aberration resulting from the arrest of downward migration of the thyroid gland. But subsequent investigations revealed clinical hypothyroidism.

  • Failure of descendence of medial anlage of thyroid gland from base of tongue to its hpothyroidism position in front of trachea leads to this aberrant growth referred to as lingual thyroid and usually goes unnoticed until late adolescence or early adulthood. Frequent follow-up and examination may be necessary during periods of metabolic stress.

  • Availability of data and materials Not applicable. Incidental lingual thyroid with subclinical hypothyroidism: case report.

  • Country of Treatment. Thyroid tissue can also be found, albeit extremely rarely, in remote structures that were associated with the thyroid anlage during development, including the esophagus, mediastinum, heart, aorta, adrenal, pancreas, gallbladder, and skin.

  • Lingual thyroid is a rare clinical entity that presents as a nodule in the base of the tongue. Surgical excision is indicated in symptomatic patients not responding to conservative management and patients with severe respiratory tract obstruction, bleeding, ulceration, and malignancy [ 3 — 10 ].

The patient was diagnosed as lingual thyroid and hypothyroidism thyroid with subclinical hypothyroidism based on clinical findings, imaging, and fine-needle aspiration cytology. Veerapandian, and S. Abstract Lingual thyroid is the result of a defective migration of the thyroid anlage occurring between the 3rd and 7th week of gestation. Rao, V. Lingual thyroid is a rare clinical entity that presents as a nodule in the base of the tongue.

Key messages Patients with hypothyroidism due to ectopic thyroid may remain symptom free and only come lingual thyroid and hypothyroidism attention after thyroid function test are carried out. J Thyroid Res. Thyroid function tests are used to evaluate the functional status of the thyroid gland. The diagnostic work-up for lingual thyroid includes CT, magnetic resonance imaging, technetium scanning, and fine needle aspiration [ 7 ]. Frequently, in these patients, lingual thyroid is detected during the diagnostic investigation of subclinical hypothyroidism. The CT scan also revealed existence of an unusual lesion—a well-defined, rounded lesion mainly of hyperdense soft tissue density—in the midline of the base of the tongue.

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