Hypertrophied residual thyroid tissue along thyroglossal tract following previous thyroidectomy

Case contributed by Assoc Prof Craig Hacking

Presentation

Fevers, severe throat pain, trismus. Difficulty swallowing.

Patient Data

Age: 50 years
Gender: Female

Mild movement artefact decreases image detail of the neck.

A midline hyperdense lobulated structure is immediately anterior to the laryngeal skeleton with a large infrahyoid component and a small anterior/suprahyoid component. The structure is adjacent to the anterior jugular vein but with no draining vessel. No thyroid tissue present in the expected location of the thyroid gland. No adjacent fat stranding or mass effect. The upper aerodigestive tract is clear.

No collection. No enlarged lymph nodes. The thyroid and salivary glands are normal in appearance. The perivertebral soft tissues are unremarkable.

IMPRESSION

  1. No neck space collection.
  2. Midline hyperdense lobulated enhancing midline structure associated with the hyoid bone and thyroid cartilage is likely residual thyroid tissue, hypertrophied along the thyroglossal duct tract after prior thyroidectomy.

Case Discussion

The patient reports undergoing total thyroidectomy 2 years earlier.

This is an interesting case of minor ectopic thyroid tissue persisting in the thyroglossal duct with subsequent hypertrophy in response to the absence of normal thyroid gland following thyroidectomy. Its midline position and relationship with the body of the hyoid bone is the key to its origin from the thyroglossal duct.

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Case information

rID: 75578
Published: 15th Jun 2020
Last edited: 3rd Mar 2021
System: Head & Neck
Inclusion in quiz mode: Included

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