Hepatic incidentaloma: An asymptomatic ectopic thyroid tissue

Ectopic thyroid in the hepatoduodenal ligament: a case report and literature review

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.

A case report of ectopic thyroid adenoma resection by transaxillary non-inflatable endoscopic surgery

INTRODUCTION AND IMPORTANCE

The ectopic thyroid gland is a rare disease in which abnormal migration of the embryonic thyroid germ is thought to be the basis for the formation of the ectopic thyroid gland.

CASE PRESENTATION

A 37 year old female sought medical attention due to feeling a sensation of swallowing foreign objects, without any other positive symptoms such as pain or difficulty breathing. Preoperative examination revealed a nodule in the left lobe of the thyroid gland and a nodule behind the left lobe. The patient ultimately underwent non-inflatable endoscopic surgery under the axilla to completely remove the tumor located in the suprasternal fossa. Postoperative pathological examination confirmed ectopic thyroid adenoma. The patient's postoperative thyroid function was normal.

CLINICAL DISCUSSION

The diagnosis of ectopic thyroid is difficult due to its highly non-specific histological characteristics and positional changes. However, clinical diagnosis and treatment should not overlook the possibility of ectopic thyroid. On the basis of completely removing the lesion, the transaxillary non-inflatable endoscopic surgery also meets the patient's minimally invasive and aesthetic needs.

CONCLUSION

The diagnosis of ectopic thyroid is difficult, and through transaxillary non-inflatable endoscopic surgery, the tumor can be completely removed and the patient's aesthetic needs can be met.