ABSTRACT
We report all year-old boy who presented with difficulty in swallowing without symptoms of hypothyroidism. The physical examination revealed a mass at the base of the tongue. The thyroid hormone profile showed a primary hypothyroidism (a serum TSH of 10.8 IU/mL with normal-low thyroxin of 6.0 fig/dL and low triiodothyronine of 57.8 ng/ dL). Antithyroid antibodies were negative. The fiberoptic endoscopy showed a reddish mass, without evidence of haemorrhage or ulceration, confirmed as a well circumscribed, hypodense mass in the base of the tongue by computed tomography of the oropharynx and neck. Tc-99-pertechnetate scanning showed an abnormal area of uptake at the base of the tongue and no uptake in the normal thyroid location, concordant with an ectopic lingual thyroid gland. Levothyroxine in a suppressive dose was started that resulted in a reduction of the size of the mass and disappearance of dysphagia.
Subject(s)
Child , Humans , Male , Deglutition Disorders/etiology , Lingual Thyroid/complications , Deglutition Disorders/diagnosis , Diagnosis, Differential , Lingual Thyroid/diagnosis , Thyroid Function Tests , Thyroid Hormones/blood , Thyrotropin/blood , Tomography, X-Ray ComputedABSTRACT
Ectopia of thyroid is a rare embryological aberration characterized by the thyroid tissue being in a site other than its usual pretracheal location. Lingual location is the most common and accounts for 90% of ectopia of thyroid gland. Most patients present with asymptomatic midline neck swelling or a mass and often pose a diagnostic challenge. Imaging plays an important role in detection of ectopic thyroid tissue and its differentiation from other mid-line swellings in the neck. We present here a case where the diagnosis was made on the basis of CT scan and confirmed by thyroid scan