Morphological Variations of the Thyroid Gland in the North Indians: A Cadaveric Study with its Clinical Relevance

Introduction: The morphological variations of the thyroid gland are not an uncommon phenomenon and may due to embryological remnant or non-specific development of different parts of it. Prior anatomical knowledge of these variations is of immense importance to prevent catastrophies during or after thyroid surgeries. Therefore, in this study we aimed to investigate the prevalence of morphological variations of the thyroid glands in north Indian cadavers. Subjects and Methods: This study was conducted on 50 formalin embalmed adult human cadavers aging between 40–65 years, of which 40 were males and 10 were females. Thyroid glands were dissected and examined properly for the presence of pyramidal lobe, levator glandulae thyroidae, accessory thyroid tissue and complete absence of isthmus. Results: The pyramidal lobe was present in 9 (18%) and frequently arising from the right side of the isthmus. LGT was found in 7 (14%) and almost in all cases it was extending from the apex of the pyramidal lobe to the hyoid bone. Only 2 (4%) cadavers did not show an isthmus while accessory thyroid tissue was found only in one case. Morphological variations were more common in females than in males and the difference was statistically significant (p value<0.05). The means of all measured parameters were higher in female than in male but these gender differences were not significant (p>0.05). Conclusion: Morphological variation of the thyroid gland is a common phenomenon, particularly in female. Hence it requires proper detection and documentation prior to any thyroid surgery, so that iatrogenic catastrophies can be avoided

Multiple Morphological Variations in the Thyroid Gland: Report of two Cases.

The variety of multiple morphological variations in the thyroid gland is found as a result of disturbed organogenesis in humans as agenesis, hypoplasia, accessory, ectopy and hemiagenesis. In the routine undergraduate dissection of the thyroid gland, multiple anomalies of the thyroid gland were encountered in 50 and 60 years old female and male cadaver respectively. These were in form of absent isthmus with accessory thyroid lobe in between two lateral lobes, pyramidal lobe arising from left lobe of thyroid with levator glandulae thyroidae in first case. Second case showed narrow isthmus related to first tracheal ring and levator glandulae thyroidae arising from left lobe. In these case studies, we highlight various developmental anomalies of the thyroid gland as absent isthmus, pyramidal lobe and accessory lobe with levator glandulae thyroidae. Hence a thorough knowledge of such morphological variations of thyroid gland helps the surgeons in better planning of safe, effective and uncomplicated operative procedures in resection of thyroid and tracheotomy procedures.

Diagnosis and treatment of ectopic thyroid / 中华内分泌外科杂志

Objective To investigate the clinical features , diagnosis and treatment of ectopic thyroid in order to avoid misdiagnosis and mismanagement .Methods Six cases of ectopic thyroid admitted to Fuzhou Gen-eral Hospital from Jan .2000 to Oct.2011 were retrospectively analyzed and the literatures were reviewed .Re-sults Three cases of ectopic thyroid were located in the anterior cervical area , 2 cases were at the base of the tongue and 1 case in the gall bladder .Two cases of aberrant thyroid were confirmed preoperatively in patients whose gland wasn't discovered by imaging examinations at the normal position of the thyroid gland .A symptomless individual of aberrant thyroid did not need other treatment but follow-up.One case with foreign body sensation in pharynx had a good response to thyroxine therapy .Four cases with accessory thyroid were operated because of misdiagnosis .Three cases were ectopic thyroid tissue and one was nodular goiter confirmed by pathology .None of these patients developed hypothyroidism after surgery .Conclusions Ectopic thyroid gland is a rare disease fre-quently misdiagnosed and mistreated .Goiters in the commonly location of ectopic thyroid gland such as the anteri-or cervical area and the base of the tongue should be paid special attention .Hormonal therapy or surgical inter-vention should be chosen according to clinical features , type of the goiter , thyroid function and whether it is be-nign or malignant .Long term follow-up and thyroid function tests are absolutely necessary .

Diagnosis and treatment of ectopic thyroid gland / 中华内分泌外科杂志

Objective To explore the clinical features, diagnosis and treatment of ectopic thyroid gland and to improve the management of ectopic thyroid. Methods The clinical data of 15 cases of ectopic thyroid in our hospital and the literatures were analyzed. The clinical features of ectopic thyroid gland, its diagnosis and the treatment were summarized. Results Of the 15 cases, 13 cases underwent operation. Among them, 9 cases showed symptom relief and their thyroid gland function resumed normal with no reoccurrence, 3 cases were complicated by temporary hypothyroidism and 1 case was misdiagnosed and mistreated, resulting in permanent hypothyroidism and lifetime thyroid hormone replacement. Conclusions Ectopic thyroid gland is a rare disease which was frequently misdiagnosed and mistreated. Improvement of related examination is essential in reducing misdiagnosis and mistreatment.