Lingual thyroid

Case contributed by Fadi Aidi
Diagnosis certain

Presentation

Headache, shortness of breath, and cough. CT of the sinuses and chest were done.

Patient Data

Age: 35 years
Gender: Female
ct

A hyperdense soft tissue mass, of the same attenuation as normal thyroid tissue seen at the base of the tongue. Absent normal thyroid tissue at its fossa. Features are those of ectopic lingual thyroid.

Case Discussion

This patient sought medical advice for reasons unrelated to the ectopic thyroid gland. Sinuses and chest CT were done, the ectopic lingual thyroid was discovered incidentally.

Ectopic thyroid is a congenital abnormality with a female predilection resulting from the complete or incomplete failure of normal caudal migration of the thyroid gland.

Lingual thyroid representing more than 90% of ectopic thyroid.

A large proportion of patients are asymptomatic and diagnosis is made incidentally, symptoms related to the lingual thyroid results from mass-effect causing dysphagia and airway obstruction (in infants) and bleeding.

Ectopic lingual thyroid usually has normal histologic and functional thyroid tissue with normal thyroid function tests seen in most patients.

Normally the thyroid gland descent from the foramen cecum down to its normal fossa anterior to the upper trachea. The ectopic thyroid may be seen anywhere along the course of the thyroglossal duct.

Nuclear studies confirm the diagnosis and identify any other radiologically-occult ectopic thyroid tissue.

No specific treatment is usually required. No increased risk of carcinoma.

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