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Zhang L, Cui X, Wang B, Du X, Hou G, Yu X. Ectopic thyroid in the hepatoduodenal ligament: a case report and literature review. Front Oncol 2024; 14:1378885. [PMID: 38711853 PMCID: PMC11071174 DOI: 10.3389/fonc.2024.1378885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/01/2024] [Indexed: 05/08/2024] Open
Abstract
Ectopic thyroid arises from abnormal development of thyroid primordial tissues as it migrates to the lower interstitium during the embryonic period, which can occur at various locations during the descent process. However, ectopic thyroid in the subdiaphragmatic area is extremely rare. In this case, we report a case of ectopic thyroid located in the hepatoduodenal ligament. The 60-year-old female patient was admitted to hospital with gallbladder stones and cholecystitis. Preoperative imaging showed a mass in the hepatoduodenal ligament. As the patient declined a needle biopsy of the mass, the nature of the mass remained unclear prior to surgery. The patient subsequently underwent laparoscopic cholecystectomy and exploratory resection of the mass. The histopathology of the resected mass showed the characteristics of ectopic thyroid, and immunohistochemical staining revealed positive expression of thyroid transcription factor-1 and thyroglobulin. The diagnosis of ectopic thyroid was established. Upon confirming the diagnosis, comprehensive neck examination revealed the presence of a normally functioning thyroid gland. Throughout the four-year follow-up period, the patient's thyroid ultrasonography and thyroid function tests indicated no abnormalities. Ectopic thyroid in the hepatoduodenal ligament and surrounding areas is an extremely rare clinical abnormality, achieving a clear diagnosis before initiating treatment offers diagnostic and treatment insights and clues for clinicians when differentiating masses within this region.
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Affiliation(s)
- Lei Zhang
- Department of Hepatobiliary Surgery, Qingdao University Affiliated Weihai Central Hospital, Weihai, Shandong, China
| | - Xijun Cui
- Department of General Surgery, Weihai Hospital of Traditional Chinese Medicine, Weihai, Shandong, China
| | - Baolei Wang
- Department of General Surgery, People’s Hospital of LongKou City, Yantai, Shandong, China
| | - Xiulan Du
- Meical Section, Qingdao University Affiliated Weihai Central Hospital, Weihai, Shandong, China
| | - Guoqi Hou
- Department of Pathology, Qingdao University Affiliated Weihai Central Hospital, Weihai, Shandong, China
| | - Xiaoqian Yu
- Department of Obstetrics, Qingdao University Affiliated Weihai Central Hospital, Weihai, Shandong, China
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2
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Charbonneau J, Lefebvre V, Bouchard P. En bloc resection of pararectal ectopic thyroid tissue: a case report. J Surg Case Rep 2023; 2023:rjad515. [PMID: 37790289 PMCID: PMC10542731 DOI: 10.1093/jscr/rjad515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
A pararectal mass' specific diagnosis can be challenging as a broad range of both benign and malignant tumors are possible. Many of these lesions are congenital and do not require treatment, if asymptomatic. Special attention is to be paid when imaging findings are not typical. In such cases, definitive diagnostic can require surgical excision. To this day, ectopic thyroid tissue was not part of known differential diagnosis. This is the first reported case of thyroid adenoma found in the perirectal area. Ectopic thyroid gland can progress over time and include malignant transformation, although rare. It needs to be considered when managing these cases, especially in unusual locations. This case report offers a systematic approach to the atypical pararectal tumor. It shares new specific clinical experience in managing a case of pararectal ectopic thyroid adenoma, from both a surgical and a histopathological point of view.
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Affiliation(s)
| | - Véronique Lefebvre
- Anatomopathology Department, Laval University, Quebec City, Quebec, Canada
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3
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Tongue Base Ectopic Thyroid Tissue-Is It a Rare Encounter? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020313. [PMID: 36837515 PMCID: PMC9959201 DOI: 10.3390/medicina59020313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
Failure in the embryological development of the thyroid in adults is rarely seen. We present the case of a 79-year-old female patient who complained of dysphagia and progressive upper respiratory obstruction, which started 12 months prior to her admission. An ENT clinical exam revealed a tongue base, spherical, well-defined tumour covered by normal mucosa. Further assessments established the diagnosis of the tongue base ectopic thyroid tissue. Due to the patient's symptoms, a transhyoid tongue base tumour removal was performed. The selected patient gave consent for participation and inclusion in this paper, in compliance with the 1964 Helsinki declaration.
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Saito M, Banno H, Ito Y, Ido M, Goto M, Ando T, Kousaka J, Mouri Y, Fujii K, Imai T, Nakano S, Tsuzuki T. Case report: surgical management of symptomatic pretracheal thyroid gland in a patient with dual ectopic thyroid. Thyroid Res 2022; 15:23. [PMID: 36503622 PMCID: PMC9743632 DOI: 10.1186/s13044-022-00141-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/02/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Dual ectopic thyroid, a very rare condition, is defined as the simultaneous presence of ectopic thyroid tissue in two abnormal locations. Here, we report the surgical management of a patient with dual ectopic thyroid. CASE PRESENTATION The patient was a 12-year-old boy with right para-midline swelling for 2 months. On physical examination of the upper anterior neck, there was a 4 cm × 3 cm mass that was soft, mobile, smooth, and painless. Blood examination showed euthyroidism. Neck ultrasonography showed a well-circumscribed multilocular cyst. We followed up by observation only because the patient had no local symptoms or malignancy. After 2 years, the mass gradually enlarged, so we performed surgery to improve cosmetic outcomes. Preoperative neck CT revealed both a high-density solid mass at the base of the tongue and a central low-density region surrounded by a high-density area at the pretracheal region below the hyoid. The infrahyoid mass was surgically removed, and the sublingual mass was left intact. Pathological findings showed the growth of multiple-size follicles, leading to a diagnosis of adenomatous goiter. Postoperative 123-I scintigraphy showed radioactive iodine uptake in the sublingual lesion, but none in the normal thyroid bed despite the extirpation of thyroid tissue. Postoperative thyroid hormone replacement was started for subclinical hypothyroidism. One year postoperatively, the patient became euthyroid. CONCLUSION Surgical excision was used to manage a symptomatic cervical infrahyoid mass related to dual ectopic thyroid. Postoperatively, thyroid hormone replacement was required both to prevent enlargement of the remaining sublingual thyroid and to maintain adequate thyroid hormone levels.
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Affiliation(s)
- Masayuki Saito
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Aichi, 480-1195, Nagakute-City, Japan
| | - Hirona Banno
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Aichi, 480-1195, Nagakute-City, Japan
| | - Yukie Ito
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Aichi, 480-1195, Nagakute-City, Japan
| | - Mirai Ido
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Aichi, 480-1195, Nagakute-City, Japan
| | - Manami Goto
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Aichi, 480-1195, Nagakute-City, Japan
| | - Takahito Ando
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Aichi, 480-1195, Nagakute-City, Japan
| | - Junko Kousaka
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Aichi, 480-1195, Nagakute-City, Japan
| | - Yukako Mouri
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Aichi, 480-1195, Nagakute-City, Japan
| | - Kimihito Fujii
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Aichi, 480-1195, Nagakute-City, Japan
| | - Tsuneo Imai
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Aichi, 480-1195, Nagakute-City, Japan
| | - Shogo Nakano
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Aichi, 480-1195, Nagakute-City, Japan.
| | - Toyonori Tsuzuki
- Hospital Pathology Department, Aichi Medical University, 1-1 Yazakokarimata, Nagakute-City, Aichi, 480-1195, Japan
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Mamone G, Caruso S, Milazzo M, Miraglia R. Case 306: Ectopic Thyroid Goiter in the Porta Hepatis. Radiology 2022; 305:242-246. [PMID: 36154285 DOI: 10.1148/radiol.210539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
HISTORY A 61-year-old woman was admitted to our institution to characterize an incidentally found mass in the porta hepatis. An episode of pulmonary embolism (18 months ago) and a pulmonary abscess (15 months ago) were reported. The patient had no history of known liver disease, previous cancer diagnosis, or trauma. She underwent total thyroidectomy for goiter several years ago, with initial iatrogenic hypothyroidism treated with levo-thyroxine hormone replacement therapy. During follow-up, this therapy was adjusted (50 μg per day) to induce euthyroidism and to achieve a target serum thyroid-stimulating hormone concentration of 1-2 mIU/L. Physical examination findings were unremarkable. Admission laboratory data were entirely normal, including tumor markers, such as carcinoembryonic antigen and carbohydrate antigen 19-9. Unenhanced and multiphasic contrast-enhanced CT imaging was performed in arterial, portal venous, and delayed (3 minutes after injection) phases. Axial and coronal maximum intensity projection reconstructed CT images were obtained in the arterial and portal venous phases. Because of the imaging findings of the mass in the porta hepatis and concerns about malignancy, the patient underwent endoscopy. Therefore, endoscopic US-guided fine-needle biopsy was performed in the same session. The patient also underwent whole-body iodine 131 (131I) scintigraphy.
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Affiliation(s)
- Giuseppe Mamone
- From the Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), via Tricomi 5, 90127 Palermo, Italy
| | - Settimo Caruso
- From the Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), via Tricomi 5, 90127 Palermo, Italy
| | - Mariapina Milazzo
- From the Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), via Tricomi 5, 90127 Palermo, Italy
| | - Roberto Miraglia
- From the Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), via Tricomi 5, 90127 Palermo, Italy
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6
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Kakamad FH, Salih AM, Ahmed SF, Abdullah HO, Kakamad SH, Mustafa SM, Mohammed SH. Thyroid and parathyroid ectopia in the mediastinum; a case report. INTERNATIONAL JOURNAL OF SURGERY OPEN 2022. [DOI: 10.1016/j.ijso.2021.100435] [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]
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7
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Chooah O, Ding J, Fei JL, Xu FY, Yue T, Pu CL, Hu HJ. Radiological insights of ectopic thyroid in the porta hepatis: A case report and review of the literature. World J Clin Cases 2021; 9:3432-3441. [PMID: 34002155 PMCID: PMC8107913 DOI: 10.12998/wjcc.v9.i14.3432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/05/2021] [Accepted: 03/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Ectopic thyroid is defined as a rare developmental anomaly where thyroid tissues are atypically found in locations other than its normal anatomical position: Anterolateral to the second, third, and fourth tracheal cartilages. An intemperate descent or a migration failure of the thyroid anlage results in sub-diaphragmatic thyroid ectopia, a sparse clinical entity.
CASE SUMMARY This case portrays a 63-year-old female patient presenting with chronic abdominal discomfort at a local hospital whereby a computed tomography (CT) scan revealed a well-defined mass in the hepatic entrance. For further examination, the patient underwent a CT scan with contrast, magnetic resonance imaging (MRI), and CT-angiography (CTA) at our department. The CT scan showed a well-defined and high attenuated mass measuring 43 mm × 38 mm in the hepatic entrance with calcification. The CTA revealed an additional finding: Blood supply to the mass from the right hepatic artery. MRI of the upper abdomen demonstrated a mass with mixed signal intensity on T1 and T2 weighted images in the hepatic entrance. The patient underwent surgery with resection of the mass which was sent for histopathology. Ectopic thyroid at the level of porta hepatis with nodules was the definitive diagnosis since histopathological report revealed presence of thyroid tissue in the resected liver mass.
CONCLUSION This case delivers a rare insight of pre-operative radiological imaging of an ectopic thyroid located in the liver. These findings can aid in narrowing down potential differential diagnosis when managing a patient with those subsequent findings.
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Affiliation(s)
- Outesh Chooah
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Jing Ding
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Jing-Le Fei
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Fang-Yi Xu
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Ting Yue
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Cai-Ling Pu
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Hong-Jie Hu
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
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8
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Zhao Z, Huang Y, Zhang X, Zhao H, Yuan X, Zhao Q, Zhang C. Da Vinci robot-assisted resection to treat abdominal ectopic thyroid: a case report and literature review. Gland Surg 2021; 10:378-385. [PMID: 33633995 DOI: 10.21037/gs-20-565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although ectopic thyroid can be found in thoracic locations, the discovery of abdominal ectopic thyroid is often an accidental event. Moreover, abdominal ectopic thyroid is easily misdiagnosed due to the rarity of these cases and the difficulties in the preoperative diagnosis process. Thus, we aimed to assess the prevalence and features of abdominal ectopic thyroid and to highlight the current knowledge about the clinical characteristics and management of this condition by analyzing a case report of abdominal ectopic thyroid and reviewing the literature. A 70-year-old woman with a 3-year history of gradually increasing abdominal distension in the right lower quadrant of the abdomen was admitted to the hospital. Contrast-enhanced computed tomography (CT) of the abdomen revealed a retroperitoneal mass. The patient underwent Da Vinci robotic surgery, and the retroperitoneal mass was completely resected. Subsequently, the pathologic diagnosis of the mass was ET. The patient had no discomfort or symptoms when she was discharged from the hospital and at the postoperative 1, 3, 6, 9 and 12 months follow-up. The summary of literature review suggested that abdominal ectopic thyroid is still rare although there are some reports. Nonetheless, the cause of abdominal ectopic thyroid is unclear, and abdominal ectopic thyroid has the following characteristics: more common in women than in men, asymptomatic in the majority of the cases, difficult to diagnose, and found by excluding metastasis. Most ectopic thyroid is treated with surgery, and minimally invasive techniques have been increasingly performed. This is the first report on Da Vinci robotic resection for large rare retroperitoneal ET, and this case highlights that ET should be considered when patients present with similar imaging findings in the abdomen.
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Affiliation(s)
- Zhanwei Zhao
- Department of General Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Yun Huang
- Department of General Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Xiliang Zhang
- Department of General Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Huibin Zhao
- Department of General Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Xinpu Yuan
- Department of General Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Qiwen Zhao
- Department of Pathology, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Chaojun Zhang
- Department of General Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
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Han S, Xie F, Li Y, You Y, Li Z, Wang X, Gao J. A dumbbell spinal mass derived from ectopic thyroid. Gland Surg 2020; 9:447-451. [PMID: 32420272 DOI: 10.21037/gs.2020.01.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Ectopic thyroid is a defect of embryologic development characterized by dislocation of the gland with or without an orthotopic thyroid gland, among other developmental issues. We report about an ectopic thyroid condition featured as an epidural dumbbell-shaped mass at the T6-7 level, also, with another gland located pre-tracheally. However, thyroid ectopy usually occurs along the trajectory of the embryologic migration of the thyroid, which is far from where the spine and spinal cord originate. To our knowledge, this is the first case reporting an ectopic thyroid tissue masquerading as a spinal neurogenic tumor but that the tumor was later confirmed to be an ectopic follicular variant of papillary thyroid carcinoma (FVPTC). Spinal epidural ectopy is a serious matter and we discuss some plausible explanations that may further our understanding of origination of ectopic thyroid.
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Affiliation(s)
- Shiyuan Han
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Fei Xie
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yongning Li
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yan You
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Zhimin Li
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xin Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jun Gao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Ma Y, Qian F, Wang J, Liu Y, Liu S. Primary accessory thyroid carcinoma with negative 99mTcO 4- SPECT/CTimaging: a case report and literature review. J Int Med Res 2019; 47:3934-3939. [PMID: 31304850 PMCID: PMC6726802 DOI: 10.1177/0300060519859738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction In contrast to orthotopic thyroid carcinoma, primary accessory thyroid carcinoma is very rare. We herein report a case involving primary accessory thyroid carcinoma in a patient with normal ultrasonography of the orthotopic thyroid and negative 99mTcO4− single-photon emission computed tomography (SPECT) scintigraphy. Case presentation: A computed tomography (CT) scan showed soft tissue nodules at the left anterior edge of the thyroid cartilage. To determine whether the mass was accessory thyroid tissue, 99mTcO4− SPECT/CT was performed, and the findings were negative. However, pathological examination after resection showed that mass was a primary accessory thyroid papillary carcinoma. The 1-year follow-up ultrasound showed no lesion at the orthotropic thyroid and neck incision sites. Conclusions This case suggests that negative 99mTcO4− SPECT/CT imaging may not completely exclude the possibility of thyroid carcinoma. A punch biopsy or postoperative pathological examination is necessary for the diagnosis.
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Affiliation(s)
- Yibo Ma
- 1 Department of Ultrasound, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Feng Qian
- 1 Department of Ultrasound, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jianfeng Wang
- 2 Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yanping Liu
- 1 Department of Ultrasound, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Shuiqing Liu
- 1 Department of Ultrasound, the Third Affiliated Hospital of Soochow University, Changzhou, China
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11
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Gu T, Lu YL, Han B, Jiang BR, Wang LZ, Yang LZ, Han YS. Ectopic thyroids have lower computed tomography attenuation values than orthotopic thyroids. Endocrine 2018; 62:546-551. [PMID: 30203122 DOI: 10.1007/s12020-018-1747-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To determine whether ectopic thyroid had the same computed tomography (CT) value as orthotopic thyroid. METHODS Twenty-one patients with 23 ectopic thyroids and 23 controls with orthotopic thyroids underwent CT scans and were included in this retrospective study. The CT images were reviewed in a blinded fashion by two radiologists. Independent-Samples T-test was used for comparison of CT attenuation values between two groups. RESULTS Ectopic thyroids had significantly lower non-enhanced attenuation (91.04 ± 5.97 Hounsfield Units vs. 106.56 ± 4.06 Hounsfield Units, P = 0.038) and contrast-enhanced attenuation (141.32 ± 6.42 Hounsfield Units vs. 169.82 ± 4.30 Hounsfield Units, P = 0.001) values than orthotopic thyroids. CONCLUSIONS Ectopic thyroids have lower CT attenuation values than orthotopic thyroids probably due to the structural or functional abnormalities. The dysgenesis and pathological changes of the ectopic thyroids may contribute to functional deficiency which finally leads to decrease of the CT attenuation values.
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Affiliation(s)
- Ting Gu
- Division of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ying-Li Lu
- Division of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bing Han
- Division of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bo-Ren Jiang
- Division of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li-Zhen Wang
- Department of Oral Pathology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li-Zhen Yang
- Division of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Yong-Shun Han
- Department of Radiology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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12
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Submental Ectopic Thyroid Cyst: An Atypical Presentation. Indian J Otolaryngol Head Neck Surg 2018; 71:712-715. [PMID: 31742048 DOI: 10.1007/s12070-018-1515-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/20/2018] [Indexed: 10/28/2022] Open
Abstract
It is very unusual of an ectopic thyroid to be presented as a submental swelling, clinically mimicking a submental cyst. Suspicious of the disease with complete clinical, biochemical and radiological correlation is the mainstay of diagnosis as the first FNAC is not confirmatory of the ectopic thyroid especially in cases of dysgenesis of thyroid tissue in an unusual location. Here we have presented a rare case of an ectopic thyroid gland presented with a submental swelling successfully managed with the conservative treatment.
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13
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Chen SH, Zheng ZY, Wang HL, Yu YH, Zeng DH, Qu LJ, Ye XZ. Thyroid-Like Intrahepatic Cholangiocarcinoma: Report of a Case and Review of the Literature. Int J Surg Pathol 2018; 26:649-654. [PMID: 29665738 DOI: 10.1177/1066896918769381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Intrahepatic cholangiocarcinoma is a relatively uncommon malignant neoplasm. We recently encountered an unusual case of intrahepatic cholangiocarcinoma that histologically resembled a thyroid carcinoma. A thorough review of the English literature revealed only 2 similar cases that have been previously reported. Immunohistochemical studies are imperative to confirm the diagnosis of cholangiocarcinoma and to exclude the possibility of metastatic thyroid carcinoma and other malignancies with thyroid-like features.
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Affiliation(s)
- Shao-Hua Chen
- 1 Department of Pathology, Fuzhou General Hospital of PLA, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou City, Fujian Province, China.,2 Department of Pathology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou City, Fujian Province, China
| | - Zhi-Yong Zheng
- 1 Department of Pathology, Fuzhou General Hospital of PLA, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Hanlin L Wang
- 3 Department of Pathology and Laboratory Medicine, University of California Los Angeles, CA, USA
| | - Ying-Hao Yu
- 1 Department of Pathology, Fuzhou General Hospital of PLA, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - De-Hua Zeng
- 1 Department of Pathology, Fuzhou General Hospital of PLA, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Li-Juan Qu
- 1 Department of Pathology, Fuzhou General Hospital of PLA, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Xian-Zong Ye
- 1 Department of Pathology, Fuzhou General Hospital of PLA, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou City, Fujian Province, China
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Abstract
RATIONALE Ectopic thyroid is commonly found in the neck region. Intra-abdominal ectopic thyroid is extremely rare, with only 2 cases reported in the pancreatic region. Very few reports have described detailed imaging findings of intra-abdominal ectopic thyroid. PATIENT CONCERNS A 73-year-old woman with aggravated recurrent right upper quadrant pain was found to have a retroperitoneal mass at the head of pancreas. Abdominal computed tomography (CT) showed a well-defined, high attenuated (56HU) mass measured of 60 × 50 mm in diameter, that exhibited heterogeneous contrast enhancement throughout the 3 phases. DIAGNOSIS Neuroendocrine neoplasm was suspected. INTERVENTIONS Following discussions with the patient, she refused fine needle aspiration cytology; however, she underwent total resection of the mass and had an uneventful clinical course. Histopathological examination showed thyroid tissue with TTF-1 and TGB positivity, and BRAF negativity, indicating a benign variant. OUTCOMES The patient had no signs of relapse with normal thyroid hormone levels after 2 years of follow up. LESSONS Ectopic thyroid tissue should be considered when patients present with similar imaging findings in abdomen. We review all reported cases of abdominal ectopic thyroid tissue to provide specific evidence for the diagnosis and treatment of this rare entity.
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Consalvo V, Barbieri G, Rossetti ARR, Romano M, Contieri R, Tramontano S, Rescigno C, Infranzi M, Lombardi D. Follicular adenoma in ectopic thyroid. A case-report. Int J Surg Case Rep 2017; 40:94-96. [PMID: 28946030 PMCID: PMC5614748 DOI: 10.1016/j.ijscr.2017.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/11/2017] [Accepted: 09/12/2017] [Indexed: 11/25/2022] Open
Abstract
Ectopic thyroid is thyroidal tissue located far from its anatomic place. A patient under our observation displayed left submandibular swelling. The FNAC test report described a follicular adenoma. Based on the FNAC diagnosis, we surgically removed the mass. The post-operative follow-up was uneventful.
Introduction The term ectopic thyroid refers to the presence of thyroid tissue located far from its usual anatomic placement and with no vascular connection to the main gland. The presence of swelling in atypical locations is diagnostically differentiated from other pathologies like pleomorphic adenoma or carcinoma, inflammatory lesions like sialadenitis, neurogenic tumors, paraganglioma, fibrolipoma and lymphadenopaties of diverse etiologies. Presentation of case Here we present the case of a submandibular ectopic thyroid in a 67 year old woman. She came to our attention for a left submandibular swelling. The anamnesis did not show related pathologies, as well as blood tests. Diagnostic image studies and a FNAC were performed. The mass was surgically removed and histopatology showed a follicular adenoma in the contest of the capsulated lesion. Discussion It is important to not underestimate these types of lesions and procede with hematochemical, instrumental tests and above all surgery that can eliminate any diagnostic uncertainty and on the whole be therapeutic. Conclusion It should not be forgotten that ectopic thyroid tissue can be a site for adenoma or papillary carcinoma and thus any watch and wait strategy should be avoided.
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Affiliation(s)
- Vincenzo Consalvo
- Università degli Studi di Salerno, Italy; Collaborator of Clinique du Parc Montpellier, France.
| | | | | | | | | | | | | | | | - Domenico Lombardi
- Hospital of Cava de' Tirreni, Università degli studi di Salerno, Italy.
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16
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Hybrid SPECT/CT Helps Characterization and Localization of a Dual Thyroid Ectopia. Clin Nucl Med 2017; 42:855-856. [PMID: 28872553 DOI: 10.1097/rlu.0000000000001824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The presence of ectopic thyroid tissue in 2 or more different sites is rare. A 12-year-old girl presented with midline anterior neck swelling in the infrahyoid region with subclinical hypothyroidism. Thyroid scanning with Tc-pertechnetate was performed, and SPECT/CT was ordered for further evaluation. Two hyperdense lesions demonstrating intense radiotracer uptake were seen in the midline at the base of the tongue and infrahyoid neck. We emphasis the role of hybrid SPECT/CT for characterization and localization of suspected ectopic thyroid tissue.
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Santangelo G, Pellino G, De Falco N, Colella G, D'Amato S, Maglione MG, De Luca R, Canonico S, De Falco M. Prevalence, diagnosis and management of ectopic thyroid glands. Int J Surg 2015; 28 Suppl 1:S1-6. [PMID: 26708843 DOI: 10.1016/j.ijsu.2015.12.043] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 04/25/2015] [Accepted: 05/10/2015] [Indexed: 12/13/2022]
Abstract
Ectopic thyroid tissue (ETT) is an uncommon entity that may be found anywhere along the line of the obliterated thyroglossal duct, usually from the tongue to the diaphragm. We performed a retrospective analysis of patients undergoing surgical treatment for thyroid disease between January 2000 and December 2013, seeking for ETT All patients with prior neck surgery or trauma were excluded. The clinic-pathologic features, prevalence and diagnosis of the lesions were collected and analyzed. Out of 3092 included patients, 28 ETT were identified (0.9%). The anatomical site of ETT was as follows: lateral cervical in 6 (21.4%), along the thyroglossal duct in 6 (21.4%), mediastinal in 5 (17.9%), lingual in 5 (17.9%), sublingual in 3 (10.7%), and submandibular in 3 (10.7%). Histopathology revealed 27 benign lesions and 1 (3.6%) papillary carcinoma. ETT is found in less than 1% of patients receiving thyroid surgery. Diagnosis of ETT requires clinical imaging. Surgery is a prudent choice due to the potential of malignant evolution of ETT.
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Affiliation(s)
- Giuseppe Santangelo
- Fifth Division of General Surgery and Special Surgical Techniques, Second University of Naples, Naples, Italy; Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Gianluca Pellino
- Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Nadia De Falco
- Fifth Division of General Surgery and Special Surgical Techniques, Second University of Naples, Naples, Italy; Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Giuseppe Colella
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - Salvatore D'Amato
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - M Grazia Maglione
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - Roberto De Luca
- Department of the Head and Neck Surgery, Second University of Naples, Naples, Italy.
| | - Silvestro Canonico
- Division of General and Geriatric Surgery, Second University of Naples, Italy.
| | - Massimo De Falco
- Fifth Division of General Surgery and Special Surgical Techniques, Second University of Naples, Naples, Italy; Division of General and Geriatric Surgery, Second University of Naples, Italy.
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Abdel Aal M, Scheer F, Andresen R. Ectopic mediastinal thyroid tissue with a normally located thyroid gland. IRANIAN JOURNAL OF RADIOLOGY 2015; 12:e7054. [PMID: 25785182 PMCID: PMC4347798 DOI: 10.5812/iranjradiol.7054] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 11/11/2012] [Accepted: 12/16/2012] [Indexed: 11/16/2022]
Abstract
Ectopic thyroid tissue (ETT) is a rare entity and a challenging differential diagnosis. This is a report of a case of a mediastinal mass that was found to be an ectopic mediastinal thyroid tissue, in a 77-year-old woman who was admitted to our hospital for breast cancer management. The mediastinal mass was identified in the postsurgical computed tomography (CT) scan of the chest and was suspected as mediastinal lymph node metastasis. A CT-guided percutaneous transthoracic punch biopsy (CT-TPB) proved to be an adequate diagnostic tool to exclude malignancy and provide a definite diagnosis of the mediastinal mass. We find that CT-guided punch biopsy as a useful diagnostic alternative enabling histopathological specimens to be obtained from mediastinal masses and lymph nodes suspected of malignancy.
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Affiliation(s)
- Mohamed Abdel Aal
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, West Kusten Klinikum Heide Academic Teaching Hospital, Universities of Kiel, Lubeck, Germany
| | - Fabian Scheer
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, West Kusten Klinikum Heide Academic Teaching Hospital, Universities of Kiel, Lubeck, Germany
| | - Reimer Andresen
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, West Kusten Klinikum Heide Academic Teaching Hospital, Universities of Kiel, Lubeck, Germany
- Corresponding author: Reimer Andresen, Institute of Diagnostic and Interventional Radiology/Neuroradiology, West Kusten Klinikum Heide Academic Teaching Hospital, Universities of Kiel, Lubeck, Germany. Tel: +49-4817852401, Fax: +49-4817852409, E-mail:
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Guerra G, Cinelli M, Mesolella M, Tafuri D, Rocca A, Amato B, Rengo S, Testa D. Morphological, diagnostic and surgical features of ectopic thyroid gland: a review of literature. Int J Surg 2014; 12 Suppl 1:S3-11. [PMID: 24887357 DOI: 10.1016/j.ijsu.2014.05.076] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 05/03/2014] [Indexed: 02/06/2023]
Abstract
Ectopic thyroid tissue remains a rare developmental abnormality involving defective or aberrant embryogenesis of the thyroid gland during its passage from the floor of the primitive foregut to its usual final position in pre-tracheal region of the neck. Its specific prevalence accounts about 1 case per 100.000-300.000 persons and one in 4.000-8.000 patients with thyroid disease show this condition. The cause of this defect is not fully known. Despite genetic factors have been associated with thyroid gland morphogenesis and differentiation, just recently some mutation has been associated with human thyroid ectopy. Lingual region in the most common site of thyroid ectopy but ectopic thyroid tissue were found in other head and neck locations. Nevertheless, aberrant ectopic thyroid tissue has been found in other places distant from the neck region. Ectopic tissue is affected by different pathological changes that occur in the normal eutopic thyroid. Patients may present insidiously or as an emergency. Diagnostic management of thyroid ectopy is performed by radionuclide thyroid imaging, ultrasonography, CT scan, MRI, biopsy and thyroid function tests. Asymptomatic euthyroid patients with ectopic thyroid do not usually require therapy but are kept under observation. For those with symptoms, treatment depends on size of the gland, nature of symptoms, thyroid function status and histological findings. Surgical excision is often required as treatment for this condition.
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Affiliation(s)
- Germano Guerra
- Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100 Campobasso, Italy.
| | - Mariapia Cinelli
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Massimo Mesolella
- Department of Neuroscience Reproductive and Dentistry Sciences, Otholaryngology Unit, University of Naples "Federico II", Naples, Italy
| | - Domenico Tafuri
- Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy
| | - Aldo Rocca
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Bruno Amato
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Sandro Rengo
- Department of Neuroscience Reproductive and Dentistry Sciences, Otholaryngology Unit, University of Naples "Federico II", Naples, Italy
| | - Domenico Testa
- Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology - Head and Neck Surgery Unit, Second University of Naples, Naples, Italy
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Scintigraphic detection of dual ectopic thyroid tissue: experience of a Chinese tertiary hospital. PLoS One 2014; 9:e95686. [PMID: 24748408 PMCID: PMC3991721 DOI: 10.1371/journal.pone.0095686] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 03/31/2014] [Indexed: 12/14/2022] Open
Abstract
Purpose To assess scintigraphic pattern, clinical indication and relevance of dual ectopic thyroid tissue (ETT). Literature is reviewed for such cases. Methods In this 5-year retrospective study, we reviewed all thyroid scintigraphies in our data base. Patients diagnosed with suspected ETT were identified. Literature is reviewed. Statistics were done by one-way analysis of variance and least significant difference test. Results From 11905 thyroid scintigraphies during the 5-year period, we retrieved 121 patients eligible for analysis. The top two indications were assessing a palpable front neck mass to determine whether it was an ETT, and primary hypothyroidism. Patients were divided into 3 groups. Group 1 with single ETT (83 cases); group 2 with dual ETT (6 cases) and group 3 with athyroid (32 cases). Age and thyroid hormones were highest in group 2, and lowest in group 3. Thyrotropin was highest in group 3, and lowest in group 2. Thyroxine was given to hypothyroid patients, while no surgery was performed. There were 42 published cases with dual ETT, most of whom were under 30 years old. 38.10% of them were euthyroid, 33.33% hypothyroid, and 21.43% subclinical hypothyroid. Most frequent ectopic positions included lingual (33.73%), sublingual (27.71%) and subhyoid (22.89%). Conclusions In our cohort, incidence of dual ETT was 0.05% if the denominator was total number of thyroid scintigraphies. The incidence was 4.96% if the denominator was the number of patients with suspected ETT. Important clinical indication is a front neck palpable mass suggestive of an ETT. Important clinical relevance of recognizing the dual ETT pattern is to avoid inappropriate surgery. After reviewing all published cases, we find dual ETT is often seen in young patients. Most of such patients are euthyroid or mildly hypothyroid. Thyroid ectopia often resides in lingual, sublingual and subhyoid areas.
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Romero-Rojas A, Bella-Cueto MR, Meza-Cabrera IA, Cabezuelo-Hernández A, García-Rojo D, Vargas-Uricoechea H, Cameselle-Teijeiro J. Ectopic thyroid tissue in the adrenal gland: a report of two cases with pathogenetic implications. Thyroid 2013; 23:1644-50. [PMID: 23510370 PMCID: PMC3868403 DOI: 10.1089/thy.2013.0063] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Ectopic thyroid tissue is usually found anywhere along the embryonic descent pathway of the medial thyroid anlage from the tongue to the trachea (Wölfler area). However, ectopic thyroid tissue in the adrenal gland (ETTAG) is not easy to understand on the basis of thyroid embryology; because it is so rare, the possibility of metastasis should first be considered. Here, we describe two cases of ETTAG with pathogenetic implications and review the associated literature. PATIENT FINDINGS Two cases of ETTAG presented as incidental cystic adrenal masses in adult females, one having a congenital hernia of Morgagni. The ETTAG was histologically indistinguishable from normal orthotopic thyroid tissue, and its follicular nature was confirmed by immunohistochemical positivity for thyroglobulin, thyroperoxidase, thyroid transcription factor-1 (TTF-1/Titf-1/Nkx2.1), cytokeratin AE1/AE3, cytokeratin 7, pendrin, human sodium iodide symporter, paired box gene 8, and forkhead box E1 (TTF-2), as well as positivity for the messenger RNA of the thyroglobulin gene by in situ hybridization analysis. No C cells (negativity for calcitonin, chromogranin, and synaptophysin) were present. Neither BRAF nor KRAS mutations were detected with real-time polymerase chain reaction analysis. Further work-up did not show evidence of thyroid malignancy. SUMMARY ETTAG is a rare finding, with only seven cases reported; women are much more frequently affected than men (8:1), and it usually presents in the fifth decade (mean age 54, range 38-67) as a cystic adrenal mass incidentally discovered on abdominal ultrasonography and/or in computed tomography images. ETTAG is composed of normal follicular cells without C cells. The expression of some transcription factors (TTF-1, paired box gene 8, and FOXE1) involved in development and/or migration of the medial thyroid anlage is preserved. Coexistence of a congenital hernia of Morgagni in one patient suggests an overdescent of medial thyroid anlage-derived cells in its pathogenesis. CONCLUSION Although ETTAG pathogenesis remains unknown, the lack of C cells together with the coexistence of a congenital defect of the anterior diaphragm (hernia of Morgagni) in one of our patients could suggest an overdescent of medial thyroid anlage-derived cells in the origin of this heterotopia.
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Affiliation(s)
| | | | - Ivonne A. Meza-Cabrera
- Department of Pathology, University Hospital San José, University of Cauca, Popayan, Colombia
| | | | - Darío García-Rojo
- Department of Urology, Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | | | - José Cameselle-Teijeiro
- Department of Pathology, Clinical University Hospital, SERGAS, Health Research Institute of Santiago de Compostela, University of Santiago de Compostela, Santiago de Compostela, Spain
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Salam M, Mohideen A, Stravitz RT. Ectopic thyroid presenting as a liver mass. Clin Gastroenterol Hepatol 2012; 10:xxx. [PMID: 22230166 DOI: 10.1016/j.cgh.2012.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 12/28/2011] [Accepted: 01/01/2012] [Indexed: 02/06/2023]
Affiliation(s)
- Maher Salam
- Department of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, Virgina, USA
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23
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Zhao Y, Pu G, Li Q, Wu M. Ectopic Thyroid Gland in the Mandible: A Case Report and Review. J Oral Maxillofac Surg 2012; 70:363-6. [DOI: 10.1016/j.joms.2011.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 05/04/2011] [Accepted: 05/25/2011] [Indexed: 11/30/2022]
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Noussios G, Anagnostis P, Goulis DG, Lappas D, Natsis K. Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity. Eur J Endocrinol 2011; 165:375-82. [PMID: 21715415 DOI: 10.1530/eje-11-0461] [Citation(s) in RCA: 207] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ectopic thyroid tissue is a rare entity resulting from developmental defects at early stages of thyroid gland embryogenesis, during its passage from the floor of the primitive foregut to its final pre-tracheal position. It is frequently found around the course of the thyroglossal duct or laterally in the neck, as well as in distant places such as the mediastinum and the subdiaphragmatic organs. Although most cases are asymptomatic, symptoms related to tumor size and its relationship with surrounding tissues may also appear. Any disease affecting the thyroid gland may also involve the ectopic thyroid, including malignancy. The clinician must distinguish between ectopic thyroid and metastatic deposits emerging from an orthotopic gland, as well as other benign or malignant masses. Thyroid scintigraphy plays the most important role in diagnosing ectopy, but ultrasonography contributes as well. In cases of symptomatic disease, surgery is the treatment of choice, followed by radioiodine ablation and levothyroxine suppression therapy in more refractory cases. This review provides current understanding about the wide clinical spectrum of this rare condition, also referring to optimal diagnostic approach, differential diagnosis, and management strategies.
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Affiliation(s)
- George Noussios
- Laboratory of Anatomy in Department of Physical Education and Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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26
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Cassol CA, Noria D, Asa SL. Ectopic thyroid tissue within the gall bladder: case report and brief review of the literature. Endocr Pathol 2010; 21:263-5. [PMID: 20714829 DOI: 10.1007/s12022-010-9130-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In this brief report, we describe a case of ectopic thyroid tissue in the gallbladder wall. We review the literature on ectopia of the thyroid and its rare occurrence outside the usual path of the migration of the thyroid anlage from the foramen caecum to the mediastinum. The importance of distinguishing ectopic thyroid from metastatic thyroid carcinoma is emphasized.
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Affiliation(s)
- Clarissa A Cassol
- Department of Pathology, University Health Network, 200 Elizabeth Street, 11th Floor, Toronto, ON M5G 2C4, Canada
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27
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Lingual thyroid: an unusual and surgically curable cause of sleep apnoea in a male. Sleep Breath 2010; 14:377-80. [DOI: 10.1007/s11325-010-0351-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Revised: 04/06/2010] [Accepted: 04/08/2010] [Indexed: 10/19/2022]
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28
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Multinodular goitre in lingual thyroid: case report. The Journal of Laryngology & Otology 2009; 124:349-51. [DOI: 10.1017/s0022215109991472] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:We report a case of a multinodular goitre developing in a lingual thyroid.Method:Case report, and discussion of the embryology and treatment of lingual thyroids.Case report:A 66-year-old woman presented with dysphagia secondary to a multinodular lingual goitre. A previously silent lingual thyroid had undergone multinodular change to cause dysphagia and eventually airway compromise. The goitre was excised via a midline, mandible-splitting approach.Conclusion:Lingual thyroids have an incidence of one in 3000 to 10 000. There has not previously been a reported case of such an ectopic gland undergoing multinodular changes and presenting in later life.
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Abellán Galiana P, Cámara Gómez R, Campos Alborg V, Rivas Sánchez A, Salom Fuster JV, Muñoz Gómez C. [Dual ectopic thyroid: subclinical hypothyroidism after extirpation of a submaxillary mass]. ACTA ACUST UNITED AC 2009; 28:26-9. [PMID: 19232175 DOI: 10.1016/s0212-6982(09)70213-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Ectopic thyroid tissue is a rare clinical entity, and more so when it is present in two different locations. We present the case of a 38-year-old euthyroid woman with submandibular and lingual ectopic thyroid tissue in the absence of a normally located thyroid gland, diagnosed after the extirpation of an asymptomatic mass misdiagnosed as a neoplasm of the submaxillary gland. Despite its low frequency, the possibility of ectopic thyroid should be considered when making a differential diagnosis of neck masses, using ultra-sound, thyroid scan and ultrasound-guided fine-needle aspiration biopsy.
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Affiliation(s)
- P Abellán Galiana
- Servicio de Endocrinología, Hospital Universitario La Fe, Valencia, España.
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Graves Disease With Midline Ectopic and Bifid Pyramidal Lobes on Pertechnetate Thyroid Scintigraphy. Clin Nucl Med 2009; 34:31-2. [DOI: 10.1097/rlu.0b013e31818f45e8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fujioka K, Fujioka A, Ban Y, Oishi M, Yano K, Sanuki E, Takahashi M, Tanaka Y, Ida M. A case of dual ectopic thyroid accompanied by positive antithyroid antibodies. J Med Ultrason (2001) 2008; 35:201. [PMID: 27278993 DOI: 10.1007/s10396-008-0198-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2007] [Accepted: 06/05/2008] [Indexed: 11/28/2022]
Abstract
Ectopic thyroid tissue is an uncommon congenital aberration that is seldom present at two different sites simultaneously. The patient was a 32-year-old woman with dual ectopic thyroid accompanied by positive antithyroid antibodies. The simultaneous occurrence of dual ectopic thyroid and positive antithyroid antibodies has been documented in only two cases: the case discussed here and one previous case. The cervical ectopic thyroid was followed up by ultrasound, which showed an increase in the size of the lesion and an internal echo texture that became slightly heterogeneous after the patient had her second child. We speculated that these changes resulted from the changes in hormone demand brought on by pregnancy and parturition.
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Affiliation(s)
- Kazumi Fujioka
- Department of Radiology, Nihon University School of Medicine, 30-1 Ohyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
| | | | - Yoshio Ban
- Department of Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Minoru Oishi
- Department of Neurology, Nihon University School of Medicine, Tokyo, Japan
| | - Kiyoshi Yano
- Department of Radiology, Nihon University School of Medicine, 30-1 Ohyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Eiichi Sanuki
- Department of Radiology, Nihon University School of Medicine, 30-1 Ohyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Motoichiro Takahashi
- Department of Radiology, Nihon University School of Medicine, 30-1 Ohyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Yoshiaki Tanaka
- Department of Radiology, Nihon University School of Medicine, 30-1 Ohyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Masahiro Ida
- Department of Radiology, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital, Tokyo, Japan
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Sood A, Sood V, Sharma DR, Seam RK, Kumar R. Thyroid scintigraphy in detecting dual ectopic thyroid: a review. Eur J Nucl Med Mol Imaging 2008; 35:843-6. [PMID: 18175113 DOI: 10.1007/s00259-007-0672-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Ectopic thyroid tissue is an uncommon congenital aberration. It is further unusual for ectopic thyroid to be present at 2 different sites simultaneously. Only 19 cases of dual ectopic thyroid have been reported in the English literature. Most of the patients were adolescents and presented with anterior neck swelling with or without altered metabolic status. Lingual/sublingual thyroid was the most common ectopic location. Subhyoid was the most common site of a second ectopic thyroid in these patients. The thyroid scan has been used successfully to diagnose ectopic thyroid tissue. We report 4 such cases in which ectopic thyroid tissue was simultaneously present at 2 different locations using thyroid scanning. The literature of already reported cases is reviewed in detail.
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Affiliation(s)
- Madhavi Chawla
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
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Kisakol G, Gonen S, Kaya A, Dikbas O, Sari O, Kiresi D, Gungor K, Karakurt F. Dual ectopic thyroid gland with Graves' disease and unilateral ophthalmopathy: a case report and review of the literature. J Endocrinol Invest 2004; 27:874-7. [PMID: 15648554 DOI: 10.1007/bf03346284] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Ectopic thyroid gland (ETG) is a rare entity and can be seen anywhere in the route of descending gland. It is much rarer when encountered away from the midline. Dual ETG is such a rare entity that only a few have been reported in the literature. ETGs not only cause thyroid dysfunction, most commonly hypothyroidism and rarely hyperthyroidism, but also frequent local symptoms. Therapeutic options change according to patients' co-morbid diseases, age, size of goiter and presence of local symptoms. Graves' disease is very rarely detected in a patient with ectopic thyroid. There is no report in literature concerning ectopic thyroid presenting with Graves' disease and unilateral ophthalmopathy. We describe a case with dual ETG and Graves' disease and unilateral ophthalmopathy: it is the first reported in literature.
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Affiliation(s)
- G Kisakol
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Meram Medical Faculty, Selcuk University, Konya, Turkey.
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Abstract
Thyroid gland organogenesis results in an organ the shape, size, and position of which are largely conserved among adult individuals of the same species, thus suggesting that genetic factors must be involved in controlling these parameters. In humans, the organogenesis of the thyroid gland is often disturbed, leading to a variety of conditions, such as agenesis, ectopy, and hypoplasia, which are collectively called thyroid dysgenesis (TD). The molecular mechanisms leading to TD are largely unknown. Studies in murine models and in a few patients with dysgenesis revealed that mutations in regulatory genes expressed in the developing thyroid are responsible for this condition, thus showing that TD can be a genetic and inheritable disease. These studies open the way to a novel working hypothesis on the molecular and genetic basis of this frequent human condition and render the thyroid an important model in the understanding of molecular mechanisms regulating the size, shape, and position of organs.
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Affiliation(s)
- Mario De Felice
- Stazione Zoologica Anton Dohrn, University of Naples Federico II, 80121 Naples, Italy
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