OBJECTIVES

To report a case of lingual thyroid in an adult woman, excised via transoral endoscopic surgery.

Design:Case Report

Setting:Tertiary Government Training Hospital

Patient:One

A 57-year-old woman consulted due to dysphagia and was initially treated for laryngopharyngeal reflux for a year. Thorough physical examination revealed a tongue base mass while imaging studies revealed the absence of thyroid in the anterior neck, and thyroid function tests revealed a hypothyroid state. The lingual thyroid was excised via transoral endoscopic surgery, confirmed as ectopic thyroid tissue on histopathology. There were no postoperative complications and the patient was discharged well, expressing high satisfaction with the resolution of her symptoms on follow-up at three months. She remains euthyroid on thyroxine replacement therapy.

The transoral endoscope-guided approach remains a valuable tool in the surgical armamentarium needed for the excision of lingual thyroids. In institutions where robotic surgery is not available, this technique is worth fostering, not only for lingual thyroids but also for lesions of the tongue base.

Ectopic thyroid means that thyroid tissue is present at an unusual area rather than at the orthotropic thyroid position. The most common form of ectopic thyroid is lingual thyroid, followed by thyroglossal duct cyst. Ectopic thyroid in the lateral neck area is extremely rare, with only a few case reports found in the literature review. Several studies recommended that metastasizing malignancy should be considered in lateral ectopic thyroid. Described here is a case of 60 year-old woman with lateral ectopic thyroid, which was newly found during a follow-up and was mistaken for metastatic lymphadenopathy.
Female ; Follow-Up Studies ; Humans ; Lingual Thyroid ; Lymphatic Diseases ; Lymphatic Metastasis ; Neck ; Thyroglossal Cyst ; Thyroid Dysgenesis ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

No abstract available.
Female ; Female* ; Humans ; Hypothyroidism* ; Lingual Thyroid* ; Ovarian Hyperstimulation Syndrome*

No abstract available.
Female ; Female* ; Humans ; Hypothyroidism* ; Lingual Thyroid* ; Ovarian Hyperstimulation Syndrome*

The aim of this study was to provide accurate anatomical descriptions of the overall anatomy of the superior thyroid artery (STA), its relationship to other structures, and its driving patterns. Detailed dissection was performed on thirty specimens of adult's cadaveric neck specimens and each dissected specimen was carefully measured the following patterns and distances using digital and ruler. The superior thyroid, lingual, and facial arteries arise independently from the external carotid artery (ECA), but can also arise together, as the thyrolingual or linguofacial trunk. We observed that 83.3% of STAs arose independently from the major artery, while 16.7% of the cases arose from thyrolingual or linguofacial trunk. We also measured the distance of STA from its major artery. The origin of the STA from the ECA was 0.9±0.4 mm below the hyoid bone. The STA was 4.4±0.5 mm distal to the midline at the level of the laryngeal prominence and 3.1±0.6 mm distal to the midline at the level of the inferior border of thyroid cartilage. The distance between STA and the midline was similar at the level of the hyoid bone and the thyroid cartilage. Also, when the STA is near the inferior border of the thyroid cartilage, it travels at a steep angle to the midline. This latter point may be particularly important in thyroidectomies. We hope that anatomical information provided here will enhance the success of, and minimize complications in, surgeries that involve STA.
Arteries* ; Cadaver ; Carotid Artery, External ; Hope ; Hyoid Bone* ; Lingual Thyroid ; Neck ; Thyroid Cartilage* ; Thyroid Gland* ; Thyroidectomy

Schwannomas are benign peripheral nerve sheath tumors. It is found rarely in the oral cavity but most commonly in the tongue followed by the palate, floor of mouth, buccal mucosa, and mandible. Because schwannoma of the base of tongue is exceedingly rare, it is often not immediately included in the differential diagnosis, causing delay in identification and treatment. We report here, with a review of the literature, a case of schwannoma of the base of tongue, which was misdiagnosed as a lingual thyroid. A 28-year-old man presented with a base of tongue mass, which was first detected a month ago. The preoperative diagnosis was lingual thyroid on the basis of the physical findings and computerized tomographic findings. The permanent pathologic report of the mass was schwannoma. Postoperatively, the patient showed no problem with tongue function and wound healing.
Adult ; Diagnosis ; Diagnosis, Differential ; Humans ; Lingual Thyroid ; Mandible ; Mouth ; Mouth Floor ; Mouth Mucosa ; Nerve Sheath Neoplasms ; Neurilemmoma* ; Palate ; Tongue* ; Wound Healing

Situs inversus totalis (SIT) is a rare congenital condition in which the viscera are transposed as a mirror of normal physiologic arrangement. We describe a rare case of lingual thyroid associated with SIT. A 64-year-old female who was diagnosed with SIT, visited our clinic due to pharyngeal foreign body sensation. Physical examination revealed a 2.5x2.5x2.0 cm sized, pinkish, round mass in the base of the tongue. Computed tomography suggested the diagnosis of lingual thyroid. She has been on regular follow up with levothyroxine therapy. To our best knowledge, this is the first case of lingual thyroid (LT) associated with SIT. The literature is reviewed and clinical features about LT and SIT are presented.
Diagnosis ; Female ; Follow-Up Studies ; Foreign Bodies ; Humans ; Lingual Thyroid* ; Middle Aged ; Physical Examination ; Sensation ; Situs Inversus* ; Thyroxine ; Tongue ; Viscera

OBJECTIVE: To describe the clinical presentation and course of seven ectopic thyroid patients.

METHODS:
Design: Retrospective Chart Review
Setting: Tertiary Government Teaching Hospital
Patient: Seven patients

RESULTS: Five patients were female and two were male (ratio of 5:2). Three belonged to the 20 to 30 year-old age group, whereas two were below 10 years of age. All seven were biochemically hypothyroid and ectopic thyroid was found to be the only functioning thyroid tissue. Three patients were managed medically with levothyroxine, while ectopic thyroid was excised in four. Ectopic thyroid tissue was autotransplanted in two cases following excision.

CONCLUSION: The ages of presentation in the present series correspond with the increased physiological demand of thyroid hormone. Thyroid substitution therapy is a must in the presence of clinical and/or biochemical hypothyroidism. Surgical excision should be avoided as far as possible especially if the ectopic tissue is the only functioning thyroid in the body. Surgery is required in selected cases presenting with obstructive symptoms or hemorrhage which are unresponsive to substitution therapy. Auto transplantation of the ectopic thyroid may not provide significant benefit to the patient and more research is warranted in this aspect.

Thyroglossal duct cyst (TGDC) and lingual thyroid (LT) are two relatively common anomalies of thyroid gland development. Each may occur without the orthotopic thyroid gland, although the co-existence of these three anomalies is very rare. The thyroidal function may be abnormal in both anomalies, and careful evaluation of thyroid function is essential for the management of these lesions. A 71-year-old woman was admitted to our department for removal of midline neck mass. She underwent the classical Sistrunk's operation, but after the surgery, her hypothyroidism became aggravated. We report, along with a literature review, an extremely rare case of co-existence of TGDC and LT in the absence of orthotopic thyroid gland.
Aged ; Female ; Humans ; Hypothyroidism ; Lingual Thyroid ; Neck ; Thyroglossal Cyst ; Thyroid Gland

A lingual thyroid is a rare developmental anomaly caused by the failure of the descent of the thyroid gland anlage early in the course of embryogenesis. The incidence of lingual thyroid has been reported to be 1/100,000. Lingual thyroid is often asymptomatic but may cause dysphagia, dysphonia, upper airway obstruction and hemorrhage. In this report, we described the case of a 50-year-old women experiencing lingual thyroid who had subclinical hypothyroidism. She underwent successful 131I ablation and has done well on thyroid hormone replacement therapy.
Airway Obstruction ; Deglutition Disorders ; Dysphonia ; Embryonic Development ; Female ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Hypothyroidism ; Incidence ; Lingual Thyroid ; Middle Aged ; Pregnancy ; Thyroid Gland