Tiroides Ectópica Lingual: caso Clínico / Lingual Ectopic Thyroid: a clinical case

La tiroides ectópica lingual es una patología muy poco frecuente, producida por la detención en el descenso normal de la glándula durante el desarrollo embrio-nario. La localización lingual de tejido tiroideo es la más común entre las tiroides ectópicas o aberrantes. Esta enfermedad puede ser asintomática pero, cuan-do los signos y síntomas están presentes, guardan estrecha correlación con la localización de la lesión y son proporcionales a su tamaño. El diagnóstico debe realizarse clínicamente y con el complemento de es-tudios por imágenes y endocrinológicos. En los aná-lisis de laboratorio se debe incluir dosaje de las hor-monas TSH, T4 libre y T3, vinculadas con la función tiroidea. Las biopsias deben evitarse ya que causan desequilibrio en la producción hormonal de la glándu-la y peligro de profusas hemorragias. En este artículo se desarrolla una descripción de las generalidades de la tiroides ectópica lingual, y se presenta un caso clínico de un niño con un tumor lingual, que fue deri-vado por su médica pediatra a cirugía para realizar una biopsia. Asimismo, se comenta la importancia que tiene para el odontólogo conocer esta patología a fin de poder evitar sus posibles complicaciones (AU)

Lingual thyroid is a rare disorder produced by a failure in the descent of thyroid gland to its normal position during embryological development. Lingual localization of thyroid tissue is the most common among the ectopic or aberrant thyroids. This condition can be asymptomatic, although when symptoms take place, they are connected to the lesion location and depend on its size. Diagnosis should be made clinically and complemented with imaging and endocrine studies. Laboratory analysis must include dosage of TSH, free T4 and T3, thyroid function-linked hormones. Due to the possible imbalance in the gland hormone production and the risk of massive bleeding, biopsy should be avoided. In this article, a brief description of lingual ectopic thyroid generalities is developed and a clinical case of a 7-years old child is provided. Additionally, dentistry importance of knowing this condition is commented, in order to prevent its possible complications (AU)

Resección transoral endoscópica de tiroides lingual / Endoscopic transoral resection of lingual thyroid

La presencia de tejido tiroideo ectópico en la base de la lengua es muy infrecuente, y la mayoría de los pacientes tienen hipotiroidismo. La indicación de tratamiento depende de la presencia o no de síntomas; la cirugía es la primera elección. Diversas técnicas quirúrgicas han sido descriptas, pero para nosotros el abordaje transoral con endoscopios constituye la mejor opción, por la buena exposición y la mínima morbilidad que produce. Se describe el caso clínico de una mujer que consultó por odinofagia, con diagnóstico de tiroides lingual y que fue tratada con éxito mediante un abordaje transoral con asistencia de endoscopios. (AU)

The presence of ectopic thyroid tissue at the base of the tongue is very rare, and most patients have hypothyroidism. The indication of treatment depends on the presence or not of symptoms, surgery being the first choice. Various surgical techniques have been described, being for us the transoral approach with endoscopes the best option, due to the good exposure, and minimum morbidity that it produces. The clinical case of a woman who consulted for odynophagia, with a diagnosis of lingual thyroid and who was successfully treated by a transoral approach with endoscopic assistance is described. (AU)

Caso Clínico: Tiroides Lingual Ectópica en Paciente Adulta Hipotiroidea. Diagnóstico Casual por Tomografía Computarizada. / Clinical Case: Ectopic Lingual Thyroid in Adult Hypothyroid Patient. Casual Diagnosis by Computed Tomography.

Introducción: Los casos de tiroides ectópica localizados en la base de la lengua son anormalidades congénitas raras y difíciles de diagnosticar. Razón de presentación del caso. Caso Clínico: El caso corresponde a una mujer de 41 años con tiroides en base de la lengua diagnosticada incidentalmente con tomografía computarizada (TC), con antecedentes de hipotiroidismo y cáncer de mama derecha. Al examen físico de cuello no se palpa glándula tiroidea ni se observa masa o protuberancia en cavidad bucal. Por control del cáncer de mama, se solicita tomografía por emisión de positrones (PET) y ecografía de cuello, reportándose captación del radiofármaco en la región cervical anterior y superior de cuello, y ausencia de tejido glandular tiroideo a nivel habitual, respectivamente. Por cuanto, se realiza TC simple y contrastada observándose a nivel de la raíz de la lengua una imagen nodular hipercaptante que mide 23x20x20 mm, bien definida, contornos regulares, no infiltra tejidos adyacentes, impronta luz de la orofaringe, sin individualizar la glándula tiroides a nivel habitual, corroborando así el diagnóstico de tiroides ectópica lingual. Conclusión: El diagnóstico de tiroides ectópica en paciente adulto hipotiroideo es raro, por lo que debe considerarse la realización de TC si al examen físico y ecográfico no es palpable ni observable

Introduction: Cases of ectopic thyroid located at the base of the tongue are rare and difficult to diagnose congenital abnormalities. Reason for presenting the case. Clinical case: The case corresponds to a 41-year-old woman with thyroid based on the tongue diagnosed incidentally with computed tomography (CT), with a history of hypothyroidism and right breast cancer. On the physical examination of the neck, the thyroid gland is not palpated, and no mass or bump is observed in the oral cavity. For breast cancer control, positron emission tomography (PET) and neck ultrasound are requested, radiopharmaceutical uptake is reported in the anterior and upper cervical neck region, and absence of thyroid glandular tissue at the usual level, respectively. As a simple and contrasted CT scan, a hypercapting nodular image measuring 23x20x20 mm, well defined, regular contours is observed at the root of the tongue, does not infiltrate adjacent tissues, oropharynx light imprint, without individualizing the thyroid gland to usual level, thus corroborating the diagnosis of lingual ectopic thyroid. Conclusion: The diagnosis of ectopic thyroid in an adult hypothyroid patient is rare, so CT should be considered if the physical and ultrasound examination is not palpable or observable.

A Case of Lateral Ectopic Thyroid Mimicking the Metastatic Lymphadenopathy / 대한이비인후과학회지

Ectopic thyroid means that thyroid tissue is present at an unusual area rather than at the orthotropic thyroid position. The most common form of ectopic thyroid is lingual thyroid, followed by thyroglossal duct cyst. Ectopic thyroid in the lateral neck area is extremely rare, with only a few case reports found in the literature review. Several studies recommended that metastasizing malignancy should be considered in lateral ectopic thyroid. Described here is a case of 60 year-old woman with lateral ectopic thyroid, which was newly found during a follow-up and was mistaken for metastatic lymphadenopathy.

Tiroides ectópica dual hiperfuncionante: abordaje quirúrgico dual / Dual hyperfunctioning thyroid ectopia: dual surgical approach

RESUMEN Paciente de 36 años en tratamiento de leucemia mieloide crónica con nilotinib a quien se le diagnostica hipertiroidismo por síntomas clínicos y exámenes de laboratorio. Se inicia tratamiento con metimazol más propanolol. Los estudios imagenológicos muestran un tejido ectópico tiroideo cervical infrahiodeo lateralizado a la izquierda y un nódulo en la base de la lengua. Presentó toxicidad hepática atribuida al tratamiento por lo que se decide extirpación quirúrgica de tiroides ectópica dual. Por la edad de la paciente y preocupación acerca del resultado estético, se realiza una tiroidectomía videoasistida por via axilar de la tiroides ectópica cervical y una resección transoral de la tiroides ectópica lingual. La patología confirma tejido tiroideo en ambas localizaciones sin signos de malignidad. La paciente se recuperó sin complicaciones y sin cicatriz cervical.

ABSTRACT A 36-year-old female patient with chronic myeloid leukemia being treated with nilotinib who was diagnosed with hyperthyroidism both on clinical and laboratory examination is presented. Imaging studies found left lateralized ectopic thyroid tissue of infrahyoid localization and a nodule at the base of the tongue. Hepatic toxicity was attributed to medical treatment, surgical removal of the dual thyroid ectopia was proposed. Due to the patients age and cosmetical concerns, a minimally invasive surgery was undertaken thru a video assisted transaxillary thyroidectomy for the cervical thyroid ectopia and a video assisted trans oral approach for the lingual thyroid ectopia. Post op pathology confirmed thyroid tissue at both locations and also excluded malignancy. The patient fully recovered without any complicaction and witout a residual cervical scar.

Cáncer diferenciado de tiroides en tiroides lingual, presentación de un caso / Differentiated thyroid cancer in the lingual thyroid, presentation of a case

The lingual thyroid carcinoma is very uncommon neoplasia with an incidence of less than 1 percent. The papillary variant is the most frequent. Cervical MRI helps differentiate muscle from thyroid tissue. The definitive diagnosis is given by histology. Management is similar to that of orthotopic thyroid cancer. We present the case of a 23-year-old woman with hypothyroidism undergoing treatment with dysphagia and sensation of pharyngeal foreign body and malodorous oral bleeding. Nasopharyngoscopy showed a rounded mass at the base of the tongue; the biopsy was compatible with thyroid neoplasia. Image study with ultrasound confirms empty thyroid bed with presence of lingual ectopic thyroid. The team of surgeons performed surgery with Trotter Technique, they removed a tumor of 4 centimeters of diameter. The definitive biopsy concludes minimally invasive follicular carcinoma. The treatment was completed with 100 mCi of radioiodine. Systemic screening at 7 days was negative, as the post-operative thyroglobulin (Tg)

Spontaneous ovarian hyperstimulation syndrome in a young female subject with a lingual thyroid and primary hypothyroidism

No abstract available.

Spontaneous ovarian hyperstimulation syndrome in a young female subject with a lingual thyroid and primary hypothyroidism

No abstract available.

Glándula tiroides lingual: diagnóstico y tratamiento / Lingual thyroid gland: diagnosis and treatment

La presencia de glándula tiroidea ectópica es una entidad rara. La tiroides lingual es la ectopía mas frecuente, predominando en mujeres. Este tejido glandular es pasible de sufrir todas las patologías que pueden afectar a la glándula normotópica, pudiendo ser sintomática o asintomática. Se presenta un caso de tiroides lingual en una paciente previamente tiroidectomizada que consultó por disnea y disfagia en la unidad de Cirugía de Cabeza y Cuello del Servicio de Otorrinolaringología del Hospital Central del Instituto de Previsión Social, Asunción, Paraguay. La paciente recibía tratamiento hormonal de reemplazo,mostrando examen funcional normal. La semiología permitió observar un abombamiento de la base de la lengua. La fibroscopía mostró un tumor en base de lengua de unos 3 cm de diámetro, que pudo evaluarse correctamente con una tomografía computada. Ante la sospecha de una tiroides lingual se realizó un centellograma que demostró captación en piso de cavidad oral. Se realizó excéresis tumoral a través de una faringotomía suprahioidea, previa traqueostomía proofiláctica. El informe de Anatomía Patológica confirmó el diagnóstico de bocio coloide ectópico.

The presence of ectopic thyroid gland is a rare entity. The lingual thyroid is the most frequent ectopy, predominating in women. This glandular tissue is capable of suffering all the pathologies that can affect the normotopic gland, being able to be symptomatic or asymptomatic. We present a case of lingual thyroid in a previously thyroidectomized patient who consulted for dyspnea and dysphagia in the Head and Neck Surgery Unit of the Otolaryngology Service of the Central Hospital of the Institute of Social Prevision, Asuncion, Paraguay. The patient received hormone replacement therapy, showing normal functional examination. Semiology allowed to observe a bulging of the base of the tongue. The fibroscopy showed atongue-based tumor about 3 cm in diameter, which could be correctly evaluated with computed tomography.Suspicion of a lingual thyroid was performed with a scintigram demonstrating uptake in the oral cavity floor.Tumor excision was performed through a suprahyoid pharyngotomy, following a prophylactic tracheostomy.The Pathologic Anatomy report confirmed the diagnosis of ectopic colloid goitre.

Anatomical considerations of the superior thyroid artery: its origins, variations, and position relative to the hyoid bone and thyroid cartilage / 대한해부학회지

The aim of this study was to provide accurate anatomical descriptions of the overall anatomy of the superior thyroid artery (STA), its relationship to other structures, and its driving patterns. Detailed dissection was performed on thirty specimens of adult's cadaveric neck specimens and each dissected specimen was carefully measured the following patterns and distances using digital and ruler. The superior thyroid, lingual, and facial arteries arise independently from the external carotid artery (ECA), but can also arise together, as the thyrolingual or linguofacial trunk. We observed that 83.3% of STAs arose independently from the major artery, while 16.7% of the cases arose from thyrolingual or linguofacial trunk. We also measured the distance of STA from its major artery. The origin of the STA from the ECA was 0.9±0.4 mm below the hyoid bone. The STA was 4.4±0.5 mm distal to the midline at the level of the laryngeal prominence and 3.1±0.6 mm distal to the midline at the level of the inferior border of thyroid cartilage. The distance between STA and the midline was similar at the level of the hyoid bone and the thyroid cartilage. Also, when the STA is near the inferior border of the thyroid cartilage, it travels at a steep angle to the midline. This latter point may be particularly important in thyroidectomies. We hope that anatomical information provided here will enhance the success of, and minimize complications in, surgeries that involve STA.

A Case of Schwannoma of the Tongue Base / 대한이비인후과학회지

Schwannomas are benign peripheral nerve sheath tumors. It is found rarely in the oral cavity but most commonly in the tongue followed by the palate, floor of mouth, buccal mucosa, and mandible. Because schwannoma of the base of tongue is exceedingly rare, it is often not immediately included in the differential diagnosis, causing delay in identification and treatment. We report here, with a review of the literature, a case of schwannoma of the base of tongue, which was misdiagnosed as a lingual thyroid. A 28-year-old man presented with a base of tongue mass, which was first detected a month ago. The preoperative diagnosis was lingual thyroid on the basis of the physical findings and computerized tomographic findings. The permanent pathologic report of the mass was schwannoma. Postoperatively, the patient showed no problem with tongue function and wound healing.

Tumor de células granulares en lengua (tumor de Abrikossoff): reporte de caso / Tongue granular cell tumor (Abrikossoff's tumor): case report / Tumor de células granulares em língua (tumor Abrikossoff): relato de caso

El tumor de células granulares (tumor de Abrikossoff) es una neoplasia benigna en un 98% de casos. Su presentación es escasa y la estirpe celular del tumor es controvertida; sin embargo, la detección positiva de proteína S-100 sugiere un origen neural. Se reporta el caso de una paciente de 16 años de edad con diagnóstico histopatológico de tumor de células granulares en el estudio de espécimen de resección quirúrgica de nódulo lingual.

The granular cell tumor (Abrikossoff's tumor) in 98% of cases is a benign neoplasm. Their presentation is rare and its histological provenience is controversial; however, the positive detection of protein S-100 suggests a neural origin. A case of a 16 years old patient is reported with histopathological diagnosis of granular cell tumor in the study of surgical resection specimen of lingual nodule.

O tumor de células granulares (Abrikossoff tumor) são tumores benignos em 98% dos casos. A frequência é rara e a linhagem celular do tumor é controversa, no entanto, a detecção positiva da proteína S-100 sugere uma origem neural. Um caso de 16 anos de idade é relatado paciente com diagnóstico histopatológico de tumor de células granulares no estudo de amostras de ressecção cirúrgica do nódulo lingual.

A Case of Contemporaneous Occurrence of Thyroglossal Duct Cyst and Lingual Thyroid without the Orthotopic Thyroid Gland / 대한이비인후과학회지

Thyroglossal duct cyst (TGDC) and lingual thyroid (LT) are two relatively common anomalies of thyroid gland development. Each may occur without the orthotopic thyroid gland, although the co-existence of these three anomalies is very rare. The thyroidal function may be abnormal in both anomalies, and careful evaluation of thyroid function is essential for the management of these lesions. A 71-year-old woman was admitted to our department for removal of midline neck mass. She underwent the classical Sistrunk's operation, but after the surgery, her hypothyroidism became aggravated. We report, along with a literature review, an extremely rare case of co-existence of TGDC and LT in the absence of orthotopic thyroid gland.

Ectopic thyroid tissue- A case series

@#<p><strong>OBJECTIVE:</strong> To describe the clinical presentation and course of seven ectopic thyroid patients. <br /><br /><strong>METHODS:<br />Design:</strong> Retrospective Chart Review<br /><strong>Setting:</strong> Tertiary Government Teaching Hospital<br /><strong>Patient:</strong> Seven patients<br /><br /><strong>RESULTS:</strong> Five patients were female and two were male (ratio of 5:2). Three belonged to the 20 to 30 year-old age group, whereas two were below 10 years of age. All seven were biochemically hypothyroid and ectopic thyroid was found to be the only functioning thyroid tissue. Three patients were managed medically with levothyroxine, while ectopic thyroid was excised in four. Ectopic thyroid tissue was autotransplanted in two cases following excision.<br /><br /><strong>CONCLUSION:</strong> The ages of presentation in the present series correspond with the increased physiological demand of thyroid hormone. Thyroid substitution therapy is a must in the presence of clinical and/or biochemical hypothyroidism. Surgical excision should be avoided as far as possible especially if the ectopic tissue is the only functioning thyroid in the body. Surgery is required in selected cases presenting with obstructive symptoms or hemorrhage which are unresponsive to substitution therapy. Auto transplantation of the ectopic thyroid may not provide significant benefit to the patient and more research is warranted in this aspect.</p>

A Case of Ectopic Lingual Thyroid with Situs Inversus Totalis / 대한갑상선학회지

Situs inversus totalis (SIT) is a rare congenital condition in which the viscera are transposed as a mirror of normal physiologic arrangement. We describe a rare case of lingual thyroid associated with SIT. A 64-year-old female who was diagnosed with SIT, visited our clinic due to pharyngeal foreign body sensation. Physical examination revealed a 2.5x2.5x2.0 cm sized, pinkish, round mass in the base of the tongue. Computed tomography suggested the diagnosis of lingual thyroid. She has been on regular follow up with levothyroxine therapy. To our best knowledge, this is the first case of lingual thyroid (LT) associated with SIT. The literature is reviewed and clinical features about LT and SIT are presented.

A Case of Non-functioning Lingual Thyroid Excised with CO₂ Laser Via Transoral Approach / 대한내분비외과학회지

Lingual thyroid, characterized by presence of thyroid tissue at the base of the tongue in the region between the circumvallate papillae and the epiglottis, is the most common location for ectopic thyroid tissue. Excision of the lingual thyroid is rarely necessary. When a lingual thyroid becomes symptomatic, removal is advocated. Minimally invasive surgical techniques have been proposed for more than two decades. The use of CO₂ laser for removal of lingual thyroid offers advantages over traditional open approaches. We experienced a case of non-functioning lingual thyroid which caused dysphagia in the patient. We successfully excised it with CO₂ laser via transoral approach without any complications.

A Case of Lingual Thyroid Treated by 131I Ablation

A lingual thyroid is a rare developmental anomaly caused by the failure of the descent of the thyroid gland anlage early in the course of embryogenesis. The incidence of lingual thyroid has been reported to be 1/100,000. Lingual thyroid is often asymptomatic but may cause dysphagia, dysphonia, upper airway obstruction and hemorrhage. In this report, we described the case of a 50-year-old women experiencing lingual thyroid who had subclinical hypothyroidism. She underwent successful 131I ablation and has done well on thyroid hormone replacement therapy.

Tiroides lingual una forma de patologia tiroidea amenazante de la vida / Lingual thyroid a life threatening form of thyroid pathology

Latiroides lingual es lavariante más común de tiroides ectópica benigna. Suele manifestarse en la infancia con hipotiroidismo o síntomas locales, como tos crónica y disfagia. Se diagnostica durante la niñez tras el comienzo de síntomas obstructivos, como la disfagia y disfonías progres ivas, obst rucción respiratoria intermitente, disnea, estridor laríngeo o sensación de cuerpo extraño. El diagnóstico por imagen ideal es la resonancia magnética. El objetivo de este artículo es presentar el caso de una lactante menor de 46 días, presentando estridor laríngeo, cianosis, disnea, secundaria a una disgenesia de tiroides debido a tiroides lingual, la cual la llevó a un hipotiroidismo secundario...(AU)