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Guo S, Xue H, Zhou J, Qin F. Ectopic thyroid carcinoma in the nasal septum: A case report. Int J Surg Case Rep 2024; 114:109193. [PMID: 38150998 PMCID: PMC10800665 DOI: 10.1016/j.ijscr.2023.109193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 12/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Ectopic thyroid carcinoma often occurs in the neck, and metastatic carcinoma of the nasal cavity and sinuses is extremely rare. CASE PRESENTATION An 11-year-old female was admitted to the hospital for one week due to nasal pain without an obvious cause and blood in the nose. A pale red mass with a peduncle at the back end of the right nasal septum was seen during the operation. Immunohistochemistry showed low-grade papillary thyroid carcinoma. CLINICAL DISCUSSION Surgeons should be alert to the possibility of ectopic thyroid tissue and related diseases, Patients with suspected malignant lesions should undergo routine pathological examination, and even a normal thyroid should be checked for malignant changes to avoid negative outcomes. CONCLUSION Although nasal endoscopic surgery is mature, for tumors with unclear properties, it is still necessary to undergo routine pathological examination to avoid habitual errors.
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Affiliation(s)
- Siquan Guo
- Department of Otorhinolaryngology, the Third Affiliated Hospital of Soochow University, the First People's Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Haixiang Xue
- Department of Otorhinolaryngology, the Third Affiliated Hospital of Soochow University, the First People's Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Jian Zhou
- Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Feng Qin
- Department of Otorhinolaryngology, Changzhou Third People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, China.
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Nguyen D, Htun NN, Wang B, Lee B, Johnson C. An Anaplastic Thyroid Carcinoma of the Giant-Cell Type from a Mediastinal Ectopic Thyroid Gland. Diagnostics (Basel) 2023; 13:2941. [PMID: 37761308 PMCID: PMC10528837 DOI: 10.3390/diagnostics13182941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 08/28/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Anaplastic thyroid carcinoma is a rare, aggressive form of thyroid carcinoma with a mean survival of less than 6 months. Ectopic thyroid tissue can be present in the mediastinum due to faulty embryogenesis with improper descent. Primary thyroid malignancies may arise from this ectopic tissue. A 90-year-old male with a history of prostatic adenocarcinoma, hypothyroidism, and occupational and therapeutic exposure to radiation presented with a rash on his chest. A review of the dermatopathology and excised mediastinal specimen revealed rare papillary foci that tested positive for thyroid markers from a background of poorly differentiated components. Molecular analysis confirmed a BRAF V600E mutation in the specimen. The final diagnosis was anaplastic thyroid carcinoma of the giant-cell type. Given the atrophic cervical thyroid tissue in the patient's neck with no evidence of previous surgery, this carcinoma was believed to arise from ectopic mediastinal tissue associated with cutaneous and bony metastasis. In conclusion, anaplastic thyroid carcinoma is an aggressive and rare thyroid malignancy that can arise from ectopic thyroid tissue in the mediastinum and should be considered in the differential diagnosis of primary undifferentiated mediastinal malignancies with bony involvement.
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Affiliation(s)
- Daniel Nguyen
- Department of Pathology and Laboratory Medicine, University of California, Irvine, CA 92868, USA; (N.N.H.); (B.W.); (B.L.); (C.J.)
| | - Nyein Nyein Htun
- Department of Pathology and Laboratory Medicine, University of California, Irvine, CA 92868, USA; (N.N.H.); (B.W.); (B.L.); (C.J.)
| | - Beverly Wang
- Department of Pathology and Laboratory Medicine, University of California, Irvine, CA 92868, USA; (N.N.H.); (B.W.); (B.L.); (C.J.)
| | - Bonnie Lee
- Department of Pathology and Laboratory Medicine, University of California, Irvine, CA 92868, USA; (N.N.H.); (B.W.); (B.L.); (C.J.)
- Department of Dermatology, University of California, Irvine, CA 92868, USA
| | - Cary Johnson
- Department of Pathology and Laboratory Medicine, University of California, Irvine, CA 92868, USA; (N.N.H.); (B.W.); (B.L.); (C.J.)
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朱 证, 廖 兵, 田 小, 刘 月. [Ectopic thyroid carcinoma in front of hyoid bone misdiagnosed as thyroglossal cyst:a case report]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:386-388. [PMID: 35483692 PMCID: PMC10128255 DOI: 10.13201/j.issn.2096-7993.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Indexed: 06/14/2023]
Abstract
A clinical case of ectopic thyroid carcinoma in front of hyoid bone was reported in this paper. The patient, a 17-year-old female, presented with an enlarging neck mass of 1-week history. Physical examination revealed a 3 cm×2 cm neck mass in front of the hyoid bone. Ultrasonographic depicted as a cystic solid mixed echogenic mass with punctate strong echogenicity. CT scan showed a cystic-solid mass in front of the hyoid bone with punctate calcifications. The patient was misdiagnosed as a thyroglossal duct cyst and underwent surgery. The final pathological diagnosis was papillary thyroid carcinoma with cyst formation.
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Affiliation(s)
- 证心 朱
- 南昌大学第二附属医院耳鼻咽喉头颈外科(南昌,330006)Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - 兵 廖
- 南昌大学第二附属医院耳鼻咽喉头颈外科(南昌,330006)Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - 小燕 田
- 南昌大学第二附属医院耳鼻咽喉头颈外科(南昌,330006)Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - 月辉 刘
- 南昌大学第二附属医院耳鼻咽喉头颈外科(南昌,330006)Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
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Shreder EV, Vadina TA, Konyukhova MB, Nagaeva EV, Shiryaeva TY, Zakharova SM, Degtyarev MV, Vyazmenov EO, Bezlepkina OB. [Ectopic thyroid gland: clinical features and diagnostics in children]. PROBLEMY ENDOKRINOLOGII 2022; 68:76-85. [PMID: 35841171 PMCID: PMC9762537 DOI: 10.14341/probl12876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND BACKGROUND: The frequency of ectopia of thyroid gland among all types of dysgenesis varies from 30 to 70%, its most common localization is the root of the tongue. Otorhinolaryngologists, oncologists, pediatricians can take lingual ectopia for hypertrophy of the lingual tonsil or fibroma of the tongue root, which leads to unreasonable surgical treatment. Thyroid scintigraphy plays a key role in the diagnosis of ectopia. AIM AIM: To assess the etiological structure of congenital hypothyroidism (CH) and demonstrate the clinical course in patients with ectopic thyroid tissue in the root of the tongue. MATERIALS AND METHODS MATERIALS AND METHODS: A group of patients with CH was examined. All patients underwent neck ultrasound and radionuclide imaging. The examination was carried out against the background of the abolition of hormone replacement therapy for 14 days or before its initiation. Patients with ectopia in the root of the tongue underwent videofibrolaryngoscopy. Some patients underwent a genetic study with using genes panel of a panel of candidate genes responsible for the development of CH using the NGS method. The molecular genetic study was conducted to some patients, next-generation sequencing with the genes panel. RESULTS RESULTS: The study included 73 patients with primary CH aged from 2 weeks to 17.3 years: 69 children were diagnosed based on the results of neonatal screening, 4 children with thyroid ectopia were first examined older than 6 years. The median age of patients at the time of the examination was 6.9 years [4.8; 10.0]. By data of ultrasound aplasia was diagnosed in 47.9% of patients, one child had hemiagenesis and ectopic thyroid tissue of various localization was detected in 26.0% of children. In 24.7% of children thyroid tissue was found in a typical location. Scintigraphy confirmed thyroid aplasia in 65.7% of children. Examination revealed various variants of ectopically located thyroid tissue in 31 children (42.4%): thyroid ectopia in the root of the tongue in 25 children (80.6%), ectopia in the sublingual region in 5 children (16.2%), double ectopia was detected in 1 child. The median level of TSH in newborns with ectopic thyroid gland was 124 IU/ml and was significantly lower than in children with aplasia — 219 IU/ml, p<0.05. On the other side the level of TG in children with ectopia was significantly higher than in children with aplasia — 37.12 ng/ml versus 0.82 ng/ml, p><0.05. CONCLUSION: Combination of two methods is the best diagnostic approach to determine the etiology of CH — ultrasound and scintigraphy studies compensates deficiencies of each other. Our study demonstrates the importance of scintigraphy in children with CH and patients with the formation of the root of the tongue and the anterior surface of the neck in order to avoid unnecessary removal of the thyroid gland. In case of confirmation of thyroid ectopia in the root of the tongue and in the absence of symptoms of obstruction or bleeding, it is recommended to refer the patient to an endocrinologist for conservative treatment. ><0.05. On the other side the level of TG in children with ectopia was significantly higher than in children with aplasia — 37.12 ng/ml versus 0.82 ng/ml, p< 0.05. CONCLUSION CONCLUSION: Combination of two methods is the best diagnostic approach to determine the etiology of CH — ultrasound and scintigraphy studies compensates deficiencies of each other. Our study demonstrates the importance of scintigraphy in children with CH and patients with the formation of the root of the tongue and the anterior surface of the neck in order to avoid unnecessary removal of the thyroid gland. In case of confirmation of thyroid ectopia in the root of the tongue and in the absence of symptoms of obstruction or bleeding, it is recommended to refer the patient to an endocrinologist for conservative treatment.
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Affiliation(s)
- E. V. Shreder
- Endocrinology Research Center;Morozov Children’s Municipal Clinical Hospital
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Sambo Salas ME, Muñoz Moreno D, Fernandez LG, Nuñez Ramos P, Cebollero Presmanes M. Papillary Thyroid Carcinoma in Ectopic Thyroid Tissue Within a Suspected Cervical Paraganglioma. Clin Nucl Med 2022; 47:e34-e36. [PMID: 34319952 DOI: 10.1097/rlu.0000000000003827] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Ectopic differentiated thyroid carcinoma represents less than 1% of all thyroid carcinoma cases, which usually arises along the cervical midline, and (delving into literature) there are scarce reports of such entity in nuclear medicine imaging studies. We present a rare case of a confirmed synchronous, orthotopic, and heterotopic (in lateral ectopic thyroid tissue) differentiated thyroid carcinoma in a patient who was previously misdiagnosed as having a cervical paraganglioma, based on compatible clinical, analytical, and imagenological (both structural and functional) findings.
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Affiliation(s)
| | | | | | - Patricia Nuñez Ramos
- Pathological Anatomy Service, Gregorio Marañón General University Hospital, Madrid, Spain
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Antón Almero M, Ferrer Ramírez MJ, Solavera R, Faubel Serra M. Lingual Thyroid Papillary Carcinoma. An Unusual Entity. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2021. [DOI: 10.1016/j.otoeng.2019.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Qin LH, He FY, Liao JY. Multiple ectopic goiter in the retroperitoneum, abdominal wall, liver, and diaphragm: A case report and review of literature. World J Clin Cases 2020; 8:6172-6180. [PMID: 33344620 PMCID: PMC7723730 DOI: 10.12998/wjcc.v8.i23.6172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/19/2020] [Accepted: 09/25/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Ectopic thyroid is a rare developmental disorder, typically found in lingual areas, and most distantly in the abdomen. Thyroid ectopia in multiple regions is extremely rare. To date, there are no reports of ectopic goiter in four regions of the abdominal cavity in a single patient. CASE SUMMARY We present a case of thyroid ectopia in four areas of the abdomen, comprising normal orthotopic thyroid tissue. A 36-year-old woman, who underwent ovarian teratoma resection 10 years previously due to symptomatic ovarian teratoma, was referred to our hospital for treatment of an incidental hepatic mass. Magnetic resonance imaging and computed tomography (CT) of the abdomen showed a heterogeneously enhanced lobulated lesion in the sixth and seventh hepatic segment adjacent to the diaphragm. The mass was surgically excised, and histologic examination determined an ectopic nodular goiter. At the one-year follow-up, the abdominal CT scan, whole-body radionuclide I131 examination, and abdominal wall biopsy showed similar lesions in the left renal fascia and anterior abdominal wall. CONCLUSION Multiple para-ectopic thyroid is often misdiagnosed, owing to its extremely rare incidence and non-specific clinical manifestations and imaging features. A combination of multiple examinations is necessary for diagnostic accuracy.
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Affiliation(s)
- Lan-Hui Qin
- Department of Radiology, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Feng-Yi He
- Department of Radiology, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Jin-Yuan Liao
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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Qin LH, He FY, Liao JY. Multiple ectopic goiter in the retroperitoneum, abdominal wall, liver, and diaphragm: A case report and review of literature. World J Clin Cases 2020. [DOI: 10.12998/wjcc.v8.i23.6165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Antón Almero M, Ferrer Ramírez MJ, Solavera R, Faubel Serra M. Lingual thyroid papillary carcinoma. An unusual entity. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020; 72:57-59. [PMID: 32197708 DOI: 10.1016/j.otorri.2019.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022]
Affiliation(s)
- María Antón Almero
- Servicio de Otorrinolaringología, Hospital General Universitario de Castellón, Castellón, España.
| | | | - Raquel Solavera
- Servicio de Otorrinolaringología, Hospital General Universitario de Castellón, Castellón, España
| | - Marta Faubel Serra
- Servicio de Otorrinolaringología, Hospital General Universitario de Castellón, Castellón, España
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Cheng TC, Lin YH. Lingual Thyroid. EAR, NOSE & THROAT JOURNAL 2019; 99:122-123. [PMID: 31852241 DOI: 10.1177/0145561319885714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Tsun-Chih Cheng
- Department of Otolaryngology, Head and Neck Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yu-Hsuan Lin
- Department of Otolaryngology, Head and Neck Surgery, National Defense Medical Center, Taipei, Taiwan
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