Importance of ectopic thyroid tissue detected in the midline of the neck: single center experience

Objective Ectopic thyroid tissue (ETT) is a rare abnormality of the thyroid gland and the true prevalence and importance is not known. The aim of this study was to evaluate ultrasonography (US) guided fine needle aspiration biposy (FNAB) results, sonographic features, and frequency of ETT detected in the midline of the neck. Subjects and methods Five thousand five hundred and twenty outpatients who were referred to our thyroid clinic between September 2010 and April 2012 and underwent thyroid US, were retrospectively analyzed. Patients with ETT, detected in the midline of the neck in US were included in the study. Thyroid functions, sonographic features, and US guided FNAB results were evaluated. Results There were 81 (81.8%) female and 18 (18.2%) male patients with a mean age of 50.9 ± 11.7. The ETT in the midline was present in 1.79% (99/5,520) of the patients. In the majority of the patients, benign sonographic features (isoechoic, regular margin, type 1 vascularization) were detected. There were 92 (92.9%) patients with a previous history of thyroidectomy and all were histopathologically benign. In 7 (7.1%) patients, there was no history of thyroid operation. FNAB results of ETT were benign. Conclusion This study evaluated the importance of ETT detected incidentally in the midline of the neck. Especially in patients with a history of thyroidectomy, the thyroid masses in the midline of the neck can be found as incidental with imaging methods. Our results suggests that the incidence of malignancy in this group is much lower than orthotopic thyroid nodules and they are often benign.

Mucosa gástrica heterotópica en esófago proximal: incidencia en nuestro medio / Incidence of heterotopic gastric mucosa of the proximal esophagus in Chile

Heterotopic Gastric mucosa (HGM) has been described in the duodenum, Meckel's diverticulum and proximal esophagus. The aim of this research was to assess the frequency and clinical aspects of HGM in cervical esophagus in a group of unselected patients. Methods: A prospective precise endoscopic evaluation, war perfomed in 200 unselected patients, referred for diagnostic upper GI endoscopy, in whom the esophageal pull through was very slow, with a careful observation of the esophagus. The presence, size, macroscopic aspects and associated symptoms were recorded. Results: Four patients (2 percent) had HGM in this serie. Lesions presented as an area of gastric appearing mucosa, surrounded for normal esophageal mucosa, with a maximum size of 2 cm. No erosions, ulcers or local malignan lesions were diagnosed. One patient had upper dysplagia. Conclusion: Systematic endoscopic examination of the upper esophagus was followed by the observation of HGM which was sometime associated to symptoms.

Se ha observado mucosa gástrica Heterotópica (MGH) en el duodeno, divertículo de Meckel, y en el esófago proximal. El objetivo del presente trabajo fué caracterizar la frecuencia y presentación de MGH en esófago cervical en un grupo no seleccionado de pacientes. Métodos: Se evaluaron endoscópicamente en forma prospectiva, 200 pacientes sucesivos, a los cuales se realizó retirada endoscópica lenta con observación minuciosa del esófago superior, se registró la presencia de MGH tamaño, aspecto macroscópico y síntomas asociados. Resultados: En 4 pacientes (2 por ciento) se encontró MGH. Un paciente presentaba disfagia moderada. Las lesiones presentaron un aspecto de mucosa gástrica en mucosa esofágica normal, sin erosiones, úlceras o sospecha de malignidad, con un diámetro máximo de 2 cm. Conclusión: La observación dirigida del esófago superior permite describir la presencia de MGH a este nivel, la que puede asociarse a sintomatología.