1
|
Ko K, Takahashi T, Honda K, Horii A. Avoiding total thyroidectomy for ectopic papillary thyroid carcinoma arising from the lateral neck. Oral Oncol 2023; 145:106501. [PMID: 37459801 DOI: 10.1016/j.oraloncology.2023.106501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/18/2023]
Affiliation(s)
- Kento Ko
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Department of Otolaryngology, Uonuma Kikan Hospital, Uonuma, Japan
| | - Takeshi Takahashi
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Kohei Honda
- Department of Otolaryngology, Uonuma Kikan Hospital, Uonuma, Japan
| | - Arata Horii
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| |
Collapse
|
2
|
HEKİMSOY İ. Diferansiye tiroit karsinomlu olgularda nadir bir tanısal yanılgı sebebi: Lateral servikal ektopik tiroit. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1208962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Ektopik tiroit genellikle boyun orta hatta izlenmekle birlikte, nadir olarak lateral yerleşimli de olabilir. Bu çalışmada diferansiye tiroit karsinomu nedeniyle total tiroidektomi uygulanan ve lateral ektopik tiroit dokusu saptanan 4 olgu sunulmaktadır. Operasyon sonrası evreleme için Tc99m perteknetat ile yapılan sintigrafi incelemesinde olguların 3’ünde submandibuler bölgede artmış tutulum izlenen alanda, ultrasonografik incelemede tiroit bezi ile eş ekojenite homojen iç yapıda ektopik tiroit dokusu saptanırken, diğer olguda alt juguler bölgede izlenen heterojen iç yapıda nodüler lezyon, yapılan santral-lateral boyun diseksiyonu sonucunda ektopik tiroit dokusu tanısı almıştır. Metastatik lenf bezi ile primer lateral ektopik tiroit dokusu ayrımı primer tiroit karsinomlu olgularda oldukça önemli olup, laboratuvar verileri, sintigrafi ve ultrasonografiyi içeren tanısal çalışma evrelemede kritik rol oynamaktadır. Oldukça nadir olmakla birlikte ektopik tiroit, lateral boyun kitlelerinin ayırıcı tanısında akılda bulundurulmalıdır.
Collapse
Affiliation(s)
- İlhan HEKİMSOY
- Medicana International İzmir Hastanesi, Radyoloji Bölümü, İzmir, Türkiye
| |
Collapse
|
3
|
Huang Q, Chen D, Ma Y. Bilateral papillary thyroid cancer with normal aberrant thyroid tissue. J Surg Case Rep 2021; 2021:rjab578. [PMID: 34987763 PMCID: PMC8711861 DOI: 10.1093/jscr/rjab578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/29/2021] [Indexed: 11/14/2022] Open
Abstract
Ectopic thyroid tissue, 90% presenting in lingual zone, is often scanned by ultra-sonography or computed tomography. Most surgeons regard ectopic thyroid as metastatic foci from thyroid cancer, thus resection is recommended. Here, we reported a man with bilateral papillary thyroid cancer, accompany with normal ectopic thyroid tissue in right sternocleidomastoid muscle. In this case, we highlighted: (i) It is rarely reported that ectopic normal thyroid tissue presented in sternocleidomastoid muscle. (ii) The ectopic thyroid tissue may not always be metastatic foci even though bilateral thyroid tumors were confirmed to be papillary cancer. (iii) Contrary to radical excision of all ectopic thyroid tissue, we advocate that only patients who need to receive the radioactive iodine therapy after total thyroidectomy should remove the ectopic normal thyroid tissue.
Collapse
Affiliation(s)
- Qingqing Huang
- Department of Surgery, Jiangyuan Hospital Affiliated to Jiangsu Institute of Nuclear Medicine, Wuxi, China
| | - Dongdong Chen
- Department of Neurosurgery, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Yi Ma
- Department of Surgery, Jiangyuan Hospital Affiliated to Jiangsu Institute of Nuclear Medicine, Wuxi, China
| |
Collapse
|
4
|
Obermueller T, von Bernstorff M, Sinn BV, Saadoun R, Gebhardt B, Hofmann VM. A rare presentation of ectopic thyroid tissue in the submandibular region: a case report. Pan Afr Med J 2021; 39:217. [PMID: 34630829 PMCID: PMC8486936 DOI: 10.11604/pamj.2021.39.217.27390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/03/2021] [Indexed: 11/18/2022] Open
Abstract
Ectopic thyroid tissue in the lateral neck is a rare finding, especially in the submandibular region. This case report presents a 38-year-old female patient with swelling in the lateral cervical neck. Due to a thyroid goitre, right hemithyroidectomy was performed in the past. However, a persistent high thyroglobulin level was detected after surgery. Regarding the suspected tumour in the submental region, a cervical magnetic resonance imaging (MRI) was performed, which revealed a suspicious looking mass. The patient underwent complete surgical excision and the histopathological report concluded that the tumour was ectopic thyroid tissue. Her thyroglobulin level decreased back to a normal level after excision of the submandibular mass. These results show that ectopic thyroid tissue must be considered a differential diagnosis for patients with unclear swelling in the submental region.
Collapse
Affiliation(s)
- Theresa Obermueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Maximilian von Bernstorff
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Bruno Valentin Sinn
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Rakan Saadoun
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruprecht-Karls-University Heidelberg, Faculty of Medicine Mannheim, Mannheim, Germany
| | - Bastian Gebhardt
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Veit Maria Hofmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| |
Collapse
|
5
|
Pederzoli S, Salviato T, Mattioli F, Di Massa G, Brigante G. Chronic thyroiditis in lateral ectopic thyroid mimicking cervical metastasis of thyroid cancer. Endocrinol Diabetes Metab Case Rep 2021; 2021:EDM210052. [PMID: 34196277 PMCID: PMC8284945 DOI: 10.1530/edm-21-0052] [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] [Received: 05/29/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022] Open
Abstract
SUMMARY We present the case of a 45-year-old Caucasian woman who attended the Endocrinology Unit for a left cervical mass discovered during follow-up for autoimmune chronic thyroiditis. The ultrasound-guided fine-needle aspiration biopsy of the lesion was consistent with a metastasis of follicular thyroid carcinoma. The sonographic neck evaluation revealed no thyroid nodules but three markedly hypoechoic and highly vascularized areas, with irregular margins and hyperechoic spots. In the clinical suspicion of primary thyroid neoplasm, ultrasound-guided fine-needle aspiration biopsy of two of the three areas was performed, but both cytological reports were non-diagnostic, revealing only colloid and blood. Subsequently, the patient underwent surgical removal of the cervical mass, with the intra-operatory consultation with frozen section examination suggesting follicular-like neoplasia. For this reason, thyroidectomy with both central and lateral neck dissection was performed. Surprisingly, the final histologic examination revealed chronic thyroiditis in the thyroid specimen and no evidence of metastasis in the left neck mass. Consequently, the pathological revision of the frozen section assessment led to the final diagnosis of chronic thyroiditis on the lateral ectopic thyroid. This case represents an uncommon example of lateral ectopic thyroid tissue with coexisting normally located thyroid tissue both affected by chronic thyroiditis. LEARNING POINTS Ectopic thyroid must be considered in the diagnostic work-up of lateral neck mass. Even if rare, ectopic thyroid tissue can be found lateral to the carotid sheath and with coexisting normally located thyroid tissue. As the orthotopic tissue, lateral ectopic thyroid tissue can be affected by chronic thyroiditis, which may complicate the diagnosis both on ultrasound and cytology.
Collapse
Affiliation(s)
- Simone Pederzoli
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Tiziana Salviato
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Mattioli
- Otolaryngology, Head and Neck Surgery Department, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Gianluca Di Massa
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Giulia Brigante
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
6
|
Kola E, Musa J, Guy A, Kola I, Horjeti E, Filaj V, Alimehmeti M. Ectopic Thyroid Papillary Carcinoma with Cervical Lymph Node Metastasis as the Initial Presentation, Accompanied by Benign Thyroid Gland. Med Arch 2021; 75:154-157. [PMID: 34219877 PMCID: PMC8228584 DOI: 10.5455/medarh.2021.75.154-157] [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: 11/25/2022] Open
Abstract
Background: Ectopic thyroid papillary carcinoma presenting as bilateral neck lymph nodes metastasis is very rare. Ectopic thyroid tissue may appear in any location along the trajectory of the thyroglossal duct from the foramen cecum to the mediastinum. It is subject to malignant transformation and is classically accompanied by a similar transformation of the native thyroid gland. Similar to that of the native thyroid gland, the most common malignancy found is Papillary thyroid carcinoma. Unusual cases in which ectopic thyroid carcinoma presents with normal native tissue support an alternative hypothesis that ectopic thyroid tissue may develop malignancies independently from the native thyroid gland. Objective: We present an extremely rare case of a 30-year-old woman previously diagnosed with Hashimoto’s thyroiditis, presenting with a palpable mass in the lateral neck suspicious for malignancy. Results: After several examinations and surgical removal of the mass, histopathologic evaluation of the continuous sections of the thyroid, demonstrated metastatic disease from papillary carcinoma of the thyroid. Total thyroidectomy and biopsy revealed benign thyroid tissue without any foci of microcarcinoma. A hypothesis of ectopic thyroid tissue and its malignant transformation was made. Conclusion: By presenting this case, our goal is to highlight and make the physicians aware of the possibility of developing primary carcinoma of the ectopic thyroid tissue, without an active tumor of the thyroid gland.
Collapse
Affiliation(s)
- Erisa Kola
- Department of Pathology, Gjirokaster Hospital, Albania
| | - Juna Musa
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Ali Guy
- Department of Physical Medicine and Rehabilitation, NY University, NY Medical Center, NY, USA
| | - Ina Kola
- Department of 'Burns and Plastic Surgery', Tirana, Albania
| | | | - Vladimir Filaj
- Department of Burns and Plastic Surgery, Tirana, Albania
| | | |
Collapse
|
7
|
Ahmedou AB, Kaoutar C, Oukessou Y, Abada R, Sami R, Mohamed R, Mohamed M, Karkouri Mehdi TC. AGGRESSIVE PAPILLARY CARCINOMA OF THE LATERAL ABERRANT THYROIDE: A CASE REPORT AND REVIEW OF THE LITERATTUREggressive papillary carcinoma of the lateral aberrant thyroide: A case report and review of the literatture. Int J Surg Case Rep 2020; 75:433-436. [PMID: 32998060 PMCID: PMC7522380 DOI: 10.1016/j.ijscr.2020.09.092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/11/2020] [Accepted: 09/11/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Ectopic thyroid tissue can be found in many sites. Ectopic thyroid tissue may also be involved in the same processes as normal thyroid gland. These processes include tumors, inflammation and hyperplasia. The appearance of such tissue in rare locations may lead to diagnostic and therapeutic dilemmas. PRESENTATION OF CCASE We report a rare case of primary papillary carcinoma in an ectopic thyroid in the jugulocarotid regionbased on the bifurcation of the carotid artery, in a 62-year-old woman with history of diabetes and high blood pressure, with a normal thyroid gland. DISCUSSION The origin of lateral ectopic thyroid tissue is not fully understood and controversial.The lateral localisation is a rare entity and debated extensively in the literature. CONCLUSION Though rare, the possibility of an ectopic thyroid carcinoma must always be considered by the surgeon in cases of a pathological mass in the neck.
Collapse
Affiliation(s)
- Ahmed Brahim Ahmedou
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Centre IBN ROCHD, Casablanca, Morocco.
| | - Chaker Kaoutar
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Centre IBN ROCHD, Casablanca, Morocco
| | - Youssef Oukessou
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Centre IBN ROCHD, Casablanca, Morocco
| | - Redallah Abada
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Centre IBN ROCHD, Casablanca, Morocco
| | - Rouadi Sami
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Centre IBN ROCHD, Casablanca, Morocco
| | - Roubal Mohamed
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Centre IBN ROCHD, Casablanca, Morocco
| | - Mahtar Mohamed
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Centre IBN ROCHD, Casablanca, Morocco
| | | |
Collapse
|
8
|
Iorio CB, Atkins KA, Nass RM, Shonka DC. Ectopic Thyroid Tissue Masquerading as a Functional Carotid Body Paraganglioma. AACE Clin Case Rep 2020; 6:e189-e192. [DOI: 10.4158/accr-2019-0553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/22/2020] [Indexed: 11/15/2022] Open
|
9
|
Sugiyama S, Iwai T, Hirota M, Mitsudo K. Ectopic Thyroid Cyst of the Lateral Neck. EAR, NOSE & THROAT JOURNAL 2020; 100:1079S-1081S. [PMID: 32579433 DOI: 10.1177/0145561320937080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Satomi Sugiyama
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Makoto Hirota
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| |
Collapse
|
10
|
Aliyev A, Ismayilov R, Seyidov N. Lateral ectopic thyroid with orthotopic multinodular goitre: A case report. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY CASE REPORTS 2020. [DOI: 10.1016/j.jecr.2020.100058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
|
11
|
Thyroid Embryonic Anomalies Involving the Medial and Lateral Anlagen: Two Surgical Case Reports. Case Rep Surg 2019; 2019:3174848. [PMID: 31886006 PMCID: PMC6915127 DOI: 10.1155/2019/3174848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 11/19/2019] [Indexed: 11/18/2022] Open
Abstract
Introduction An ectopic anomalous accessory thyroid is extremely rare. We present two related case reports. Case A 43-year-old morbidly obese female presented with a palpable left thyroid mass. Initial impression after preoperative workup was a diffuse bilateral multinodular goiter with a left nodule suspicious for malignancy. She underwent a total thyroidectomy. On further palpation after initial excision, two masses on the left neck area were noted, dissected, and excised. In the second case, a 65-year-old female presented with a substernal exophytic mass displacing the trachea to the right after a left thyroid lobectomy 4 years ago. Cytology revealed a retained substernal thyroid. She is scheduled for a substernal thyroidectomy through a median sternotomy. Discussion In all partial or complete thyroidectomy cases, care should be taken to palpate or to use intraoperative ultrasound (IOUS) for any extra thyroid mass. An intuitive surgical approach is needed to evaluate for possible embryologic anomalies of the thyroid. There are two thyroid anlagen that can explain ectopic aberrant anomalies: the median anlage-thyroid rest and the lateral anlage from the ultimobranchial body of the fourth pharyngeal pouch. Surgeons should keep in mind that multiple ectopic thyroid glands could be present in any thyroidectomy procedure.
Collapse
|
12
|
Makwana M, Walsh S, Gangoli S. An unexpected finding from a submental mass. BJR Case Rep 2019; 5:20180094. [PMID: 31501703 PMCID: PMC6726178 DOI: 10.1259/bjrcr.20180094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/06/2018] [Accepted: 12/19/2018] [Indexed: 11/08/2022] Open
Abstract
This case describes a fit and well 17-year-old male who underwent surgical resection of a longstanding, painless, right lateral neck swelling. Believed to be either a vascular malformation, ranula or enlarged sublingual gland from pre-operative MR studies, histopathological examination of the mass revealed it as normal thyroid tissue. Post-operative imaging confirmed the absence of any remaining thyroid tissue. Hypothyroidism was confirmed with subsequent thyroid function tests. Interestingly, a "thyroid storm" which presented unknowingly during the surgical removal of the lesion did not trigger suspicion that thyroid tissue was being handled at the time. Normal, ectopic thyroid tissue in the lateral neck is rare but should be considered a differential diagnosis for neck lumps, particularly if it also presents as an intraoral swelling, as in this case. The presence of the orthotopic thyroid gland should be confirmed with diagnostic imaging prior to surgical excision of unknown neck masse.
Collapse
|
13
|
Batchala PP, Dyer A, Mukherjee S, Rehm PK. Lateral ectopic thyroid mimics carotid body tumor on Indium-111 pentetreotide scintigraphy. Clin Imaging 2019; 58:46-49. [PMID: 31238185 DOI: 10.1016/j.clinimag.2019.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/20/2019] [Accepted: 05/24/2019] [Indexed: 12/29/2022]
Abstract
A 34-year old woman with past history of anxiety, depression, and hypothyroidism resulting from prior total thyroidectomy for multinodular goiter presented with complaints of palpitations, sweating, and tachycardia. Clinical examination revealed a painless right lateral neck mass. USG/CT of the neck revealed the soft tissue mass located at the right carotid bifurcation. A subsequent Indium-111 pentetreotide somatostatin receptor scintigraphy (SRS) demonstrated tracer uptake in the mass. Hence, secretory carotid body tumor/paraganglioma was strongly suspected. However, post-surgical histopathological specimen revealed only benign thyroid follicles indicative of lateral ectopic thyroid with no evidence of neuroendocrine cells or malignancy. This case highlights the importance of considering lateral ectopic thyroid, a very rare entity, in the differential diagnosis for carotid bifurcation masses. Also highlighted is the false positivity from normal but ectopic thyroid tissue on Indium-111 pentetreotide SRS mimicking a paraganglioma.
Collapse
Affiliation(s)
- Prem P Batchala
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA
| | - Anthony Dyer
- School of Medicine, University of South Carolina, Columbia, SC, USA
| | - Sugoto Mukherjee
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA
| | - Patrice K Rehm
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA.
| |
Collapse
|
14
|
Chahed H, Kharrat G, Bechraoui R, Marrakchi J, Mediouni A, Amor MB, Zainine R, Beltaief N, Besbes G. Ectopic thyroid tissue: unusual differential diagnosis of cervical paraganglioma. Pan Afr Med J 2017; 27:43. [PMID: 28761619 PMCID: PMC5516674 DOI: 10.11604/pamj.2017.27.43.11495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 04/16/2017] [Indexed: 11/13/2022] Open
Abstract
Ectopic thyroid tissue (ETT) lateral to the midline is rare. Its occurrence in the carotid bifurcation is exceptional. We present a 45 years woman who consulted with a slow growing right cervical swelling. Clinical examination Ultrasonography, contrast enhanced CT and cervical MRI concluded to a paraganglioma. Intra-operatively, the tumor didn’t have the characteristic aspect of a paraganglioma. Complete excision was performed. Histology concluded to an ectopic micro-vesicular thyroid adenoma.Previous literature was reviewed to summarize clinical and radiologic characteristics of such rare entity. Despite its rarity, ETT must be included in the differential diagnosis of cervical paraganglioma.
Collapse
Affiliation(s)
- Houda Chahed
- Department of Oto-Rhino-Laryngology and Cervico-Facial Surgery of 'Rabta' Hospital Tunisia, Medecine Faculty, El ManarUniversity, Tunisia
| | - Ghada Kharrat
- Department of Oto-Rhino-Laryngology and Cervico-Facial Surgery of 'Rabta' Hospital Tunisia, Medecine Faculty, El ManarUniversity, Tunisia
| | - Rim Bechraoui
- Department of Oto-Rhino-Laryngology and Cervico-Facial Surgery of 'Rabta' Hospital Tunisia, Medecine Faculty, El ManarUniversity, Tunisia
| | - Jihene Marrakchi
- Department of Oto-Rhino-Laryngology and Cervico-Facial Surgery of 'Rabta' Hospital Tunisia, Medecine Faculty, El ManarUniversity, Tunisia
| | - Azza Mediouni
- Department of Oto-Rhino-Laryngology and Cervico-Facial Surgery of 'Rabta' Hospital Tunisia, Medecine Faculty, El ManarUniversity, Tunisia
| | - Mohamed Ben Amor
- Department of Oto-Rhino-Laryngology and Cervico-Facial Surgery of 'Rabta' Hospital Tunisia, Medecine Faculty, El ManarUniversity, Tunisia
| | - Rim Zainine
- Department of Oto-Rhino-Laryngology and Cervico-Facial Surgery of 'Rabta' Hospital Tunisia, Medecine Faculty, El ManarUniversity, Tunisia
| | - Nejeh Beltaief
- Department of Oto-Rhino-Laryngology and Cervico-Facial Surgery of 'Rabta' Hospital Tunisia, Medecine Faculty, El ManarUniversity, Tunisia
| | - Ghazi Besbes
- Department of Oto-Rhino-Laryngology and Cervico-Facial Surgery of 'Rabta' Hospital Tunisia, Medecine Faculty, El ManarUniversity, Tunisia
| |
Collapse
|
15
|
Papillary Thyroid Carcinoma: Ectopic Malignancy versus Metastatic Disease. Case Rep Endocrinol 2017; 2017:9707031. [PMID: 28702266 PMCID: PMC5494070 DOI: 10.1155/2017/9707031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/15/2017] [Accepted: 04/02/2017] [Indexed: 11/28/2022] Open
Abstract
Papillary thyroid carcinoma frequently metastasizes to regional lymph nodes. However, cervical lymph node metastasis as a sole manifestation of occult papillary thyroid carcinoma is rarely observed. Ectopic thyroid is an uncommon condition defined as the presence of thyroid tissue at a site other than pretracheal area. Approximately 1–3% of all ectopic thyroid tissue is located in the lateral neck. This entity may represent the only functional thyroid tissue in the body. Malignant transformation of ectopic thyroid is uncommon; but even rarer is the development of papillary carcinoma on it. We present a case of a 33-year-old man with an incidental lateral neck mass diagnosed after a motor vehicle accident. Total thyroidectomy and lymph node resection were completed without evidence of papillary thyroid carcinoma. Malignant transformation of heterotopic thyroid tissue was the final diagnosis. The possibility of an ectopic thyroid cancer should be considered in the differential diagnosis of a pathological mass in the neck. The uniqueness of this case strives in the rarity that the thyroid gland was free of malignancy, despite ectopic tissue being positive for thyroid carcinoma. Management strategies, including performance of total thyroidectomy, neck dissection, and treatment with radioiodine, should be based on individualized risk assessment.
Collapse
|
16
|
Paragliola RM, Papi G, Lovicu RM, Pontecorvi A, Corsello SM. A Rare Case of Lateral Ectopic Thyroid. Clin Nucl Med 2016; 41:936-937. [PMID: 27749423 DOI: 10.1097/rlu.0000000000001401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Ectopic thyroid tissue is an abnormality caused by aberrant thyroid gland embryogenesis during its passage from the floor of the primitive foregut to its final position. The most frequent place of ectopic thyroid tissue is the base of tongue, whereas lateral thyroid gland is a very rare finding. The present case describes a case of thyroid dysgenesis, caused by a submandibular ectopic thyroid gland. Thyroid scintigraphy was crucial for the diagnosis: in fact, the patient was asymptomatic, and the diagnosis was performed only on the basis of subclinical hypothyroidism.
Collapse
|
17
|
Kalnina M, Pramalte A, Zemniece L, Safronov Y. Acute infectious thyroiditis in ectopic lingual thyroid causing dysphagia and dyspnoea: a case report and discussion. BJR Case Rep 2016; 3:20160025. [PMID: 30363312 PMCID: PMC6159276 DOI: 10.1259/bjrcr.20160025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 07/21/2016] [Accepted: 08/09/2016] [Indexed: 11/05/2022] Open
Abstract
Acute infectious thyroiditis in patients with ectopic lingual thyroid gland is extremely rare, and in most cases, this condition, if symptomatic, manifests as dysphagia and dyspnoea. This case report shows that, in addition to the previously mentioned typical symptoms, our patient also suffered from febrile temperature, progressive fullness in the throat and pain during swallowing. Diagnosis of acute infectious thyroiditis associated with lingual thyroid gland is complex and requires evaluation of results of clinical findings and laboratory tests, and also evaluation by radiological diagnostic methods. Treatment was performed by administering antibacterial and anti-inflammatory therapy, resulting in the disappearance of complaints. Clinical appearance, diagnostic methods and treatment options are discussed in the discussion section.
Collapse
Affiliation(s)
- Marika Kalnina
- Nuclear Medicine Department, Nuclear Medicine Centre, Ltd, Riga, Latvia
| | - Anda Pramalte
- Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Liene Zemniece
- Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Yegor Safronov
- Department of Otorhinolaryngology, Pauls Stradins Clinical University Hospital, Riga, Latvia
| |
Collapse
|
18
|
Thyroid computed tomography imaging: pictorial review of variable pathologies. Insights Imaging 2016; 7:601-17. [PMID: 27271508 PMCID: PMC4956631 DOI: 10.1007/s13244-016-0506-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 05/03/2016] [Accepted: 05/24/2016] [Indexed: 12/25/2022] Open
Abstract
Abstract Focal and diffuse thyroid abnormalities are commonly encountered during the interpretation of computed tomography (CT) exams performed for various clinical purposes. These findings can often lead to a diagnostic dilemma, as the CT reflects the nonspecific appearances. Ultrasound (US) examination has a superior spatial resolution and is considered the modality of choice for thyroid evaluation. Nevertheless, CT detects incidental thyroid nodules (ITNs) and plays an important role in the evaluation of thyroid cancer. In this pictorial review, we cover a wide spectrum of common and uncommon, incidental and non-incidental thyroid findings from CT scans. We also discuss the most common incidental thyroid findings, best practices for their evaluation, and recommendations for their management. In addition, we explore the role of imaging in the assessment of thyroid carcinoma (before and after treatment) and preoperative thyroid goiter, as well as localization of ectopic and congenital thyroid tissue. Teaching Points • Thyroid disorders tend to have non-specific CT appearances. • ITNs are common on neck CT. • ITN management depends on nodule size, age, health status, lymphadenopathy, and invasion. • CT is used in assessment of cancer extension, mass effect, invasion, and recurrence. • CT plays a role in preoperative planning in patients with symptomatic goiter.
Collapse
|
19
|
Submandibular Lateral Ectopic Thyroid Tissue: Ultrasonography, Computed Tomography, and Scintigraphic Findings. Case Rep Otolaryngol 2015; 2015:769604. [PMID: 26634164 PMCID: PMC4655019 DOI: 10.1155/2015/769604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/01/2015] [Indexed: 12/04/2022] Open
Abstract
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.
Collapse
|
20
|
Primary papillary carcinoma arising from ectopic thyroid tissue in the cervical lymph node: A case report. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2015. [DOI: 10.1016/j.ajoms.2014.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
21
|
Zander DA, Smoker WRK. Imaging of ectopic thyroid tissue and thyroglossal duct cysts. Radiographics 2015; 34:37-50. [PMID: 24428281 DOI: 10.1148/rg.341135055] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
When a child or young adult presents with a mass in the anterior portion of the neck, diagnostic considerations include a thyroglossal duct cyst and ectopic thyroid tissue. These entities are often suspected clinically, and imaging provides an opportunity to evaluate the extent, confirm the diagnosis, and evaluate for complications. Imaging characteristics of a thyroglossal duct cyst as a simple cyst and of ectopic thyroid tissue as a hyperattenuating soft-tissue mass can help identify these lesions at computed tomography (CT); however, intrinsic magnetic resonance, CT, and ultrasonographic imaging characteristics alone cannot be used to confirm the diagnosis. Rather, knowledge of the typical course of the thyroid primordium during embryologic development is essential to understand the variant locations along this path where thyroid tissue can be found. The migration of thyroid primordium begins at the foramen cecum at the base of the tongue and then loops around the hyoid bone anteriorly and inferiorly and descends anteriorly to the thyrohyoid membrane into the orthotopic location in the infrahyoid portion of the neck. Thyroid ectopia is categorized into one of four typical locations with respect to this embryologic course: (a) the base of the tongue, (b) adjacent to the hyoid bone, (c) the midline infrahyoid portion of the neck, and, rarely, (d) the lateral part of the neck. The differential diagnosis includes metastatic thyroid carcinoma, branchial cleft cyst, lymphatic malformation, abscess, saccular cyst, epidermoid cyst, and squamous cell carcinoma. The relationship of a mass to landmarks such as the foramen cecum, hyoid bone, strap muscles, thyrohyoid membrane, and thyroid cartilage can help differentiate a thyroglossal duct cyst and ectopic thyroid tissue from other anterior neck masses when the embryologic thyroid course is considered.
Collapse
Affiliation(s)
- David A Zander
- From the Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242
| | | |
Collapse
|
22
|
Lin CY, Yang TL. Lingual Thyroid: Ultrasound Assessment and Diagnosis. J Med Ultrasound 2014. [DOI: 10.1016/j.jmu.2014.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
23
|
Peterson ME, Broome MR. THYROID SCINTIGRAPHY FINDINGS IN 2096 CATS WITH HYPERTHYROIDISM. Vet Radiol Ultrasound 2014; 56:84-95. [DOI: 10.1111/vru.12165] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 03/06/2014] [Indexed: 11/28/2022] Open
|