Ectopic submandibular thyroid tissue with a coexisting normally located multinodular goitre: case report and review of the literature

Follicular adenoma with a papillary architecture originating from an ectopic thyroid gland: a case report

BACKGROUND

Follicular adenomas with papillary architecture are rare tumors of thyroid origin and are composed of completely encapsulated follicular cells with a papillary architecture lacking the nuclear characteristics of papillary carcinoma. Herein, we present a case of follicular adenoma with papillary architecture originating from an ectopic thyroid gland, diagnosed from a mass in the submandibular region.

CASE PRESENTATION

A 70-year-old woman was referred to our hospital with the chief complaint of a painless left submandibular mass that had been present for one year. The patient underwent left submandibular dissection for therapy and diagnosis. Microscopically, papillary lesions with fibrovascular cores were observed in the interior, and the epithelial cells were cylindrical in shape with eosinophilic cytoplasm, round or oval nuclei, with no pathological features, leading to a diagnosis of papillary carcinoma or follicular carcinoma. The mass was diagnosed as a follicular thyroid adenoma with papillary architecture. This is the first report of a follicular adenoma with a papillary architecture originating from an ectopic thyroid gland.

CONCLUSION

This experience suggests that follicular adenoma should be included in the differential diagnosis of ectopic thyroid tumors.

Ectopic goitrous submandibular thyroid with goitrous orthotopic thyroid gland

Ectopic thyroid is a rare developmental anomaly with lingual thyroid accounting for majority of the cases. The presence of ectopic thyroid tissue lateral to the midline is very rare, and very few cases located in the submandibular region have been reported. The simultaneous finding of submandibular ectopic thyroid tissue and a functional orthotopic thyroid gland is even rarer. In the differential diagnosis of an ectopic submandibular thyroid, it is fundamental to exclude a metastasis from well-differentiated thyroid cancer, even when primary thyroid carcinoma is not demonstrable.

Submandibular Lateral Ectopic Thyroid Tissue: Ultrasonography, Computed Tomography, and Scintigraphic Findings

Ectopic thyroid can be encountered anywhere between the base of tongue and pretracheal region. The most common form is euthyroid neck mass. Herein, we aimed to present the findings of a female case with ectopic thyroid tissue localized in the left submandibular region. A 44-year-old female patient, who underwent bilateral subtotal thyroidectomy four years ago with the diagnosis of multinodular goiter, was admitted to our hospital due to a mass localized in the left submandibular area that gradually increased in the last six months. Neck ultrasonography, contrast-enhanced computed tomography, and scintigraphic examination were performed on the patient. On thyroid scintigraphy with Tc-99m pertechnetate, thyroid tissue activity uptake showing massive radioactivity was observed in the normal localization of the thyroid gland and in the submandibular localization. The focus in the submandibular region was excised. Pathological examination of the specimen showed normal thyroid follicle cells with no signs of malignancy. The submandibular mass is a rarely encountered lateral ectopic thyroid tissue. Accordingly, ectopic thyroid tissue should also be considered in the differential diagnosis of masses in the submandibular region.

A case of pediatric ectopic thyroid in lateral lymph nodes

On average, ectopic thyroids are positioned in the embryotic decent path that emerges as a lingual thyroid or a thyroglossal duct cyst. It is uncommon for ectopic thyroids to be located in the lateral neck, which only represents 1%-3% of all cases. Any ectopic thyroids that emerge in the posterior lateral neck in pediatric patients should be regarded as an extremely unique case. We report a 13-year-old boy with ectopic thyroid tissue in the cervical lymph nodes with orthotopic euthyroid thyroid. The masses were located on the left posterior triangle area, which were confirmed as histologic benign thyroid tissue without any malignancy in the head and neck. Authors suggest that this case supports the benign lymphatic transport theory of lateral ectopic thyroid.