Functional lingual thyroid in an adolescent female: a case report and brief literature review.

Background: Lingual thyroid is a rare clinical entity that represents faulty migration of normal thyroid gland. It commonly presents as a benign mass found at the junction of the anterior two-thirds and posterior one-third of the tongue. Although usually asymptomatic, glandular hypertrophy can cause dysphonia, dysphagia, bleeding, or stridor at any time from infancy through adulthood. We report a case that we encountered, discuss the diagnosis and its management, and review the literature. An otherwise asymptomatic 14 year-old girl presented with a posterior tongue mass that had been present since childhood but was never investigated. She was clinically and biochemically euthyroid, with normal thyroid function tests. Physical examination revealed a smooth, globular mass occupying the whole tongue base and valleculae. The epiglottis was slightly displaced posteriorly but the laryngeal inlet was patent. A 99mTcradioisotope scan showed accumulation of tracer in the tongue base and no uptake in the neck. MRI revealed a 1.8-cm diameter soft tissue mass in the posterior part of the tongue. To date she has not required suppressive therapy or surgical intervention. Conclusions: Treatment of lingual thyroid depends on patient symptoms. Most importantly, patients should be followed at regular intervals and educated on the possibility of developing complications.

A rare case of laryngeal Kaposi’s sarcoma.

Kaposi’s sarcoma (KS) is the most common malignancy observed in patient with acquired immune deficiency syndrome (AIDS). It rarely causes upper airway obstruction. We report a 39-year-old gentleman, a former intravenous drug user with AIDS and Hepatitis C positive who developed progressive hoarseness with stidor. He underwent an emergency tracheostomy and direct laryngoscopy revealed a whitish globular laryngeal mass obscuring the glottic region. A biopsy of the mass was taken and the histopathological report showed evidence of spindle cell connective tissue, consistent with Kaposi’s sarcoma. It is important for clinicians or surgeons to maintain a high index of suspicion for the diagnosis of laryngeal KS in immunodeficiency patient even without cutaneous manifestation.