ABSTRACT
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)
Subject(s)
Humans , Female , Middle Aged , Surgical Procedures, Operative/methods , Tongue Neoplasms/surgery , Lingual Thyroid/surgery , Signs and Symptoms , Surgical Procedures, Operative/classification , Thyroxine/administration & dosage , Tongue Neoplasms/pathology , Tongue Neoplasms/diagnostic imaging , Enalapril/therapeutic use , Pharyngitis , Lingual Thyroid/physiopathology , Lingual Thyroid/therapy , Lingual Thyroid/epidemiology , Lingual Thyroid/diagnostic imaging , Dyspnea , Endoscopy/methods , Hemorrhage , Hypertension/drug therapy , Hypothyroidism/complicationsABSTRACT
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.
Subject(s)
Humans , Female , Adult , Lingual Thyroid/surgery , Lingual Thyroid/diagnostic imaging , Lingual Goiter/surgery , Lingual Goiter/diagnostic imagingABSTRACT
Lingual thyroid is an uncommon developmental abnormality which results from the failure of the thyroid gland to descend from the foramen coecum to its prelaryngeal site. Diagnosis is assessed by the clinical picture and thyroid uptake scintiscans. Treatment is essentially medical although surgery is indicated when compression occurs. In this report, we describe two cases of lingual thyroid which were diagnosed because of an obstructive oropharyngeal syndrome in one case and hypothyroidism in the other one
Subject(s)
Humans , Male , Female , Thyroid Gland , Hypothyroidism , Magnetic Resonance Imaging , Lingual Thyroid/diagnostic imagingABSTRACT
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