Hemiagenesia tiroidea: caso clínico y revisión de la literatura / Thyroid hemiagenesis: clinical case and review of the literature

La hemiagenesia tiroidea representa un trastorno congénito caracterizado por la ausencia de desarrollo de uno de los lóbulos tiroideos, asociado o no a ausencia del istmo. Es más frecuente en las mujeres y por lo general se presenta como falta del lóbulo izquierdo, con hipertrofia compensatoria del lóbulo contralateral. Su diagnóstico es generalmente incidental o por manifestaciones del lóbulo tiroideo presente. Se hizo una revisión bibliografía, en donde no se encontraron casos reportados en Venezuela de hemiagenesia o agenesia tiroidea, describiéndose el siguiente. Presentamos a una paciente de 50 años de edad, conocida con hipotiroidismo desde los 31 años, negando cualquier cirugía en el área de cabeza y cuello. Desde febrero 2019 presentó aumento progresivo de volumen en región anterior de cuello. Al examen físico se observó aumento de volumen en región anterior derecha del cuello, palpándose lóbulo tiroideo derecho aumentado de tamaño, de aspecto nodular, no doloroso. En ecosonograma tiroideo se concluyó como bocio tiroideo derecho de aspecto multinodular, con ausencia del lóbulo izquierdo. Perfil tiroideo dentro de límites normales. Se lleva a mesa operatoria corroborándose ausencia del lóbulo izquierdo y presentado en la biopsia definitiva hiperplasia nodular en el lóbulo derecho. Se discute su frecuencia, la forma de presentación y se hace revisión de la literatura(AU)

Thyroid hemiagenesis represents a congenital disorder characterized by the absence of development of one of thyroid lobes, associated or not with absence of isthmus. It is more frequent in women and generally presents as absence of the left lobe, with compensatory hypertrophy of the contralateral lobe. Its diagnosis is generally incidental or by manifestations of the present thyroid lobe. A bibliography review was made, where no cases reported in Venezuela of hemiagenesis or thyroid agenesis were found, describing the following. We present a 50-year-old patient, known with hypothyroidism since she was 31, denying any surgery in the head and neck area. Since February 2019, presented a progressive increase in volume in the anterior neck region. On physical examination, an increase in volume was observed in right anterior region of the neck, palpating an enlarged right thyroid lobe, with a nodular appearance and not painful. In a thyroid echo-sonogram, it was concluded as a right thyroid goiter with a multinodular appearance, with the absence of the left lobe. Thyroid profile within normal limits. It is taken to the operating table, confirming the absence of the left lobe and presented in the definitive biopsy nodular hyperplasia in the right lobe. Its frequency, form of presentation, and literature review are discussed(AU)

Thyroid Hemiagenesis Associated with Papillary Thyroid Carcinoma

Thyroid hemiagenesis is a rare congenital anomaly that is caused by a developmental defect of a thyroid. Previous reports indicate that thyroid cancer associated with hemiagenesis is extremely rare. A 47-year-old woman presented with single nodule in the right thyroid gland that was incidentally detected during a routine medical checkup. Ultrasonography showed a 1.5×1.2 cm sized ill-defined irregular hypoehoic nodule in the right thyroid and the isthmus was present. However, the left thyroid was not seen and thyroid was disconnected at left paraisthmic area. Fine-needle aspiration cytology confirmed that the right thyroid nodule was papillary thyroid carcinoma. Total thyroidectomy with bilateral central compartment node dissection was performed. Permanent pathologic finding was 1.3×1 cm sized classical type papillary thyroid carcinoma with nodular hyperplasia. There was extensive lymphatic invasion and 3 metastatic lymph nodes out of 4 in central compartment. In conclusion, although thyroid hemiagenesis associated with thyroid carcinoma is extremely rare, treatment strategy is not different with patients with normal anatomy. And the possibility of developing a thyroid carcinoma should be considered in patients with hemiagenesis. Furthermore, it requires awareness of anatomical difference around the thyroid gland during operation.

Thyroid Hemiagenesis Associated with Papillary Carcinoma

This paper reports a rare case of a left sided thyroid hemiagenesis associated with papillary carcinoma. Thyroid hemiagenesis is a rare congenital anomaly resulted from failure of development on one of the thyroid lobes. Among several thyroid developmental anomalies, hemiagenesis is considered to be the rarest anomaly. In world literature to date, only about 310 cases have been reported. We present a case of thyroid hemiagenesis of the left lobe and isthmus in a 51-year-old female, along with radiological and operative findings. Our report can give the idea that the thyroid hemiagenesis may not influence the development of parathyroid glands.

Hemiagénesis tiroidea de lóbulo derecho: comunicación de un caso / Right thyroid hemiagenesis and microcarcinoma of the left lobe: report of one case

In congenital thyroid hemiagenesis, one of the thyroid lobes, usually the left one, does not develop. This condition is generally asymptomatic. We report a 47 years old female with a diffuse left goiter. An ultrasound detected the right lobe hemiagenesis. She was subjected to a subtotal thyroidectomy. The pathological study of the surgical piece disclosed the presence of an encapsulated papillary carcinoma, follicular variant with a diameter of 2 mm.

La hemiagénesis tiroidea es una anormalidad congénita inhabitual en la cual uno de los lóbulos de la tiroides no se desarrolla. Su prevalencia es desconocida, debido a que generalmente es asintomática. Damos cuenta del caso de una mujer de 47 años, con bocio difuso de predominio izquierdo, operada, con presencia de microcarcinoma papilar en el lóbulo remanente. La detección de la hemiagénesis tiroidea es usualmente casual durante el examen de la glándula tiroides por otras causas. Es más frecuente en mujeres que en hombres (3:1), y el lóbulo izquierdo suele estar más comprometido que el derecho. Este caso muestra la inhabitual hemiagénesis tiroidea derecha con presencia de microcarcinoma papilar latente.

Thyroid Hemiagenesis Associated with Micropapillary Thyroid Carcinoma

Thyroid hemiagenesis of one lobe of the thyroid is a rare congenital anomaly in which one lobe of the thyroid gland fails to develop. It is more frequently found in women than in men, and absence of the left lobe is more common. The variations of prevalence of the anomaly have been reported to be around 0.05~0.2%. Patients with thyroid hemiagenesis are usually asymptomatic and discovered incidentally with other pathologic condition such as a benign adenoma, multinodular goiter, hyperthyroidism or carcinomas. We report a 29-year-old woman with an incidentally discovered hemiagenesis of the right thyroid.

A Case of Thyroid Hemiagenesis

Thyroid hemiagenesis is a rare congenital anomaly in which one thyroid lobe fails to develop. Thyroid hemiagenesis usually does not cause clinical symptoms by itself, therefore, this anomaly is detected incidentally during the evaluation of other thyroid disorders. We describe a rare case of thyroid hemiagenesis in a 1-month-old female infant who presented with prolonged jaundice and abnormal laboratory findings of congenital hypothyroidism. The patient showed the characteristic features of thyroid hemiagenesis of the left lobe in Tc-99m pertechnetate scintigraphy and ultrasonography of the thyroid gland. The patient has improved with supportive care, including thyroid hormone replacement. Further long-term follow-up is required for the investigation of recurrence of thyroid abnormalities.

Thyroid Hemiagenesis: Case Report / 대한이비인후과학회지

Thyroid hemiagenesis is a very rare abnormality, where one thyroid lobe fails to develop. Most patients diagnosed with the disease have associated thyroidal diseases. We report a 32-year-old female who presented with the left thyroid mass that had gradually increased in size over two years. Thyroid scan revealed the absence of right lobe and isthmus and a hypoactive nodule in the lower pole of left lobe. Ultrasonography confirmed the right lobe and the isthmus agenesis. The operative findings confirmed hemiagenesis of the right lobe and nodular hyperplasia in the left lobe. The purpose of this report is to present a case of nodular hyperplasia, where agenesis of the contralateral lobe was also observed.

A Case of Thyroid Hemiagenesis / 대한내분비외과학회지

Thyroid hemiagenesis is considered to be a rare congenital anomaly, but its incidence is propabley underestimated because the diagnosis is usually incidental. The left lobe is absent four times as often as the right and women are about three times more likely to have this developmental defect. Many of these patients are hyperthyroid or medical attention. We present the case of a 14-year-old women with right thyroid hemiagenesis associated without other thyroid disorders. The diagnosis of hemiagenesis was established by isotope imaging and thyroid ultrasound. In most of the clinical reports on thyroid hemiagenesis, an association with other thyroid disorders was found such as hyperthyroidism, multinodular goitre, hypothyroidism, benign adenama, Graves' disease, acute and subacute thyroiditis, and carcinoma. Even if morphology and function of thyroid gland is normal on diagnosis, a follow-up survey should be recommended.

A Case of Thyroid Hemiagenesis / 대한내분비외과학회지

Thyroid hemiagenesis is considered to be a rare congenital anomaly, but its incidence is propabley underestimated because the diagnosis is usually incidental. The left lobe is absent four times as often as the right and women are about three times more likely to have this developmental defect. Many of these patients are hyperthyroid or medical attention. We present the case of a 14-year-old women with right thyroid hemiagenesis associated without other thyroid disorders. The diagnosis of hemiagenesis was established by isotope imaging and thyroid ultrasound. In most of the clinical reports on thyroid hemiagenesis, an association with other thyroid disorders was found such as hyperthyroidism, multinodular goitre, hypothyroidism, benign adenama, Graves' disease, acute and subacute thyroiditis, and carcinoma. Even if morphology and function of thyroid gland is normal on diagnosis, a follow-up survey should be recommended.

Thyroid Hemiagenesis

Thyroid anomaly are rare embryological condition. The failure of the development of one lobe leading to unilateral agenesis is the rarest of all the thyroid anomalies, The cause of unilateral agenesis is unknown. Thyroid hemiagenes is common in females (3: 1) with the left lobe being absent. The common disease in the remaining lobe is a benign adenoma, a multinodular goiter, hyperthyroidism, chronic thyroiditis, and rarely carcinoma. The most common pathology involved in thyroid hemiagenesis is hyperthyroidism. This report the case of a 57-year-old woman with a right thyroid hemiagenesis.

Thyroid Hemiagenesis and Ectopic Thymus at Thyroid Bed, and Papillary Cancer in Opposite Thyroid Lobe with Hyperthyroidism

Thyroid hemiagenesis is a development failure of one of the thyroid lobes, predominantly in females with a left lobe. The associated disease in the remaining thyroid lobe include benign adenoma, multinodular goiter, hyperthyroidism, chronic thyroiditis, and carcinoma etc. We report a very rare case of thyroid hemiagesesis with hyperthyroidism, thyroid cancer, and ectopic thymus. A 43-year-old female presented with hyperthyoidism and thyroid nodule. Thyroid scan with 99mTcO4 revealed cold nodule in left lobe with absent right lobe. The patient underwent thyroid exploration. Because nodule in the remaining thyroid lobe proved to be a thyroid cancer on frozen biopsy, total thyroidectomy was performed. There was a thyroid-like tissue at the right side (scan 'absent' side) and removed. Pathology confirmed that the removed tissue from right side was thymus. There has been no report in world literatures of such case; in one patient, thyroid hemiagenesis, hyperthyroidism, thyroid carcinoma, and ectopic thymus coexists. We report the case and review the literature on thyroid hemiagenesis and ectopic thymus.

A Case of Thyroid Hemiagenesis with Papillary Adenocarcinoma / 대한내분비학회지

Variation in the gross anatomy of the thyroid is relatively common. Although thyroid hemiagenesis is considered to be a rare congenital anomaly, its incidence is probably underestimated because the diagnosis is usually incidental.We present the case of a 26-year-old woman with right thyroid hemiagenesis associated with papillary adenocarcinoma. The diagnosis of hemiagenesis was established by isotope imaging, which showed hot nodule, thyroid ultrasonography and surgical exploration for proper management of a nodule in the left lobe of thyroid gland. As she was diagnosed to have papillary adenocarcinoma, total thyroidectomy was performed and at present she remains disease-free.