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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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Di Stefano C, Guarnotta V, Barbaccia M, Paratore R, La Monica R, Lo Casto A, Midiri M, Gruttadauria S, Giordano C, Richiusa P. Hepatic incidentaloma: An asymptomatic ectopic thyroid tissue. Front Endocrinol (Lausanne) 2022; 13:1066188. [PMID: 36578960 PMCID: PMC9791092 DOI: 10.3389/fendo.2022.1066188] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
An ectopic thyroid is a form of thyroid dysgenesis in which the entire thyroid gland or parts of it may be located in another part of the body than the usual place. The most frequent location is the base of the tongue. Although most cases are asymptomatic, symptoms related to tumor size and its relationship with surrounding tissues, hormonal dysfunction, and seldom malignancy may also occur. Here, we describe the case of an asymptomatic woman who was thyroidectomized 19 years previously for a toxic goiter and treated with conventional L-thyroxine therapy, until we enacted a progressive reduction of dosage of the replacement therapy. Incidentally, because of occasional abdomen discomfort, she was hospitalized in our Division of Endocrinology as there was ultrasound evidence of a large mass in the liver dislocating and imprinting the choledochal duct in the pre-pancreatic site, the gallbladder, and the cystic duct, which could not be dissociated from the contiguous hepatic parenchyma and was in very close proximity to the second duodenal portion and the head of the pancreas. Imaging techniques, such as TC, MR, TC/PET, and 131I scintigraphy, confirmed the large lesion with a diameter on the axial plane of about 8 × 5.5 cm and a cranio-caudal extension of about 6 cm. The impossibility of surgical debulking and/or radiometabolic 131I therapy, in the absence of compression symptoms, led to the multidisciplinary decision of a clinical and instrumental follow-up of this rare lesion.
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Affiliation(s)
- Claudia Di Stefano
- Section of Endocrinology and Diabetology, Health Promotion, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, PROMISE, University of Palermo, Palermo, Italy
| | - Valentina Guarnotta
- Section of Endocrinology and Diabetology, Health Promotion, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, PROMISE, University of Palermo, Palermo, Italy
| | - Maria Barbaccia
- Department of Pathology, Diagnostic and Therapeutic Services, IRCCS ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione)-UPMC (University of Pittsburgh Medical Center), Palermo, Italy
| | - Rosario Paratore
- Section of “Medicina Nucleare e Terapia Radiometabolica”, La Maddalena, Palermo, Italy
| | - Roberta La Monica
- Section of Endocrinology and Diabetology, Health Promotion, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, PROMISE, University of Palermo, Palermo, Italy
| | - Antonio Lo Casto
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Radiology, University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Radiology, University of Palermo, Palermo, Italy
| | - Salvatore Gruttadauria
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center), Palermo, Italy
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Carla Giordano
- Section of Endocrinology and Diabetology, Health Promotion, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, PROMISE, University of Palermo, Palermo, Italy
- *Correspondence: Carla Giordano, ; Pierina Richiusa,
| | - Pierina Richiusa
- Section of Endocrinology and Diabetology, Health Promotion, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, PROMISE, University of Palermo, Palermo, Italy
- *Correspondence: Carla Giordano, ; Pierina Richiusa,
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