Intrathyroidal carotid artery and nonrecurring right recurrent laryngeal nerve: A case report

The combined intrathyroidal course of the brachiocephalic artery, right common carotid artery and right subclavian artery

PURPOSE

We present an extremely rare vascular variant in which the brachiocephalic artery, right common carotid artery, and right subclavian artery course through the right lobe of the thyroid gland.

METHODS

A 54-year-old woman underwent a coronary computed tomography (CT) angiography examination with the suspicion of infective endocarditis.

RESULTS

Unexpectedly, the distal brachiocephalic artery, the proximal right common carotid artery, and right subclavian artery had a course through the right lobe of the thyroid gland. Otherwise, the arcus aorta branching pattern was normal.

CONCLUSION

The supraaortic major branches seldom have intrathyroidal course. The intrathyroidal course of the right common carotid artery was described previously only in one case. But, to our best knowledge, the combined intrathyroidal course of these three major vessels has not been previously reported. Although asymptomatic, such variations may complicate lower neck procedures involving thyroidectomies and thyroid biopsies if undetected and unreported. So, the awareness of this atypical course while reporting CT examinations is crucial prior to neck interventions.

Ultrasonography of Extrathyroidal Diseases Mimicking Intrinsic Thyroid Lesions

Some localized or multisystem diseases as well as congenital anomalies occasionally involve thyroid and unusual findings will be identified during thyroid ultrasonography. Recognition of these entities will minimize unnecessary complementary examination and lead to appropriate management for patients. Therefore, we aim to review sonographic features of these extrathyroidal diseases that affect thyroid in adults. Our review derives from cases diagnosed in our hospital and published literature, with pictures accessible using as illustration. These disorders included intrathyroidal parathyroid adenoma, intrathyroidal cystic findings of nonthyroid origin, metastases to the thyroid, esophageal diverticulum, paratracheal air cysts, and ossification of anterior longitudinal ligament.