Ectopic thyroid tissue is a rare pathological finding bellow the diaphragm and extremely rare finding is ectopic thyroid tissue in the adrenal gland (ETTAG). Thyroid tissue can be located anywhere along the way of embryological migration pathway of thyroglossal duct. In most cases of ectopic thyroid tissue, it is located in the neck. Here we present a case of 29 years old patient that was laparoscopically operated because of adrenal incidentaloma which showed 28 mm in maximal diameter on MRI. The patient had normal adrenal function. Pathohistological finding confirmed ETTAG. Follicular cells express TTF-1, Thyroglobulin, PAX8, and cytokeratin 7, and lack expression of calretinin. This is the 15th such case described in literature. Women are much more affected than men (14:1), and it usually presents in the fifth decade (mean age 49). In all cases ETTAG was composed of normal follicular cells, and C cells were not found. Review of the literature reveals that adrenal ectopic thyroid tissue is almost always cystic, and has distinctive pathologic features. The most important thing is that ETTAG must be distinguished from metastatic deposits from thyroid gland carcinoma.Our patient had normal thyroid function, without any nodules in thyroid gland. We report the youngest patient with ectopic thyroid tissue located in the adrenal gland.

Ectopic thyroid tissue is a rare pathological finding bellow the diaphragm and extremely rare finding is ectopic thyroid tissue in the adrenal gland. Thyroid tissue can be located anywhere along the way of embryological migration pathway of thyroglossal duct. In most cases of ectopic thyroid tissue, it is located in the neck. Pathohistologically ectopic thyroid tissue in all cases was formed of follicular cells that expressed TTF-1, Thyroglobulin, PAX8, and cytokeratin 7, and there was lack expression of calretinin. In the literature we found 15 such cases. Women are much more affected than men (14:1), and it usually presents in the fifth decade (mean age 49). In all cases it was composed of normal follicular cells, and C cells were not found. Review of the literature reveals that adrenal ectopic thyroid tissue is almost always cystic, and has distinctive pathologic features. The most important thing is that ectopic thyroid tissue must be distinguished from metastatic deposits from thyroid gland carcinoma.

Psychosis is a set of symptoms that lead to contact disorders or even cessation of contact with reality. It can be in the form of disorders of perception, emotions, thoughts, and behavior. Psychosis has many causes, and one of them is hypothyroidism. Thyroxin is important for the global function of brain activity, cholinergic activity in the frontal cortex and hippocampus increases significantly in its presence. The diagnosis of psychotic episodes is made on the basis of autoanamnesis and heteroanamnesis, as well as psychiatric examination. The presence of: positive syndrome, disorganization and negative syndrome. After the diagnosis of a psychotic disorder, antipsychotics are included in the therapy, and upon arrival, the findings that verify hypothyroidism, include thyroxin in the therapy. The therapeutic response is achieved after a few days or a week. In patients with an acute psychosis, and especially in those with a positive personal and family history of hypothyroidism, one should think in the direction of an unrecognized endocrine disease.

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Introduction. Parathyroid cysts are divided into two categories: functional and nonfunctional. Both types of parathyroid cysts, if they are large enough, can represent as mediastinal or neck mass in 1-5 %. Case series. We have analyzed data of the patients operated from 2016 till 2021 due to primary hyperparathyroidism or because of cervical/mediastinal mass. Review of patients demographic data, preoperative fine needle aspiration biopsy, level of parathyroid hormone in serum pre and postoperative, level of serum calcium, clinical presentation of disease was done. Total of 555 patients were operated in this period pathological confirmation of parathyroid gland. Parathyroid cysts were found in seven cases. In five cases cyst was nonfunctional. Four female and three male were operated due to parathyroid cyst. Mean age of operated patients was 49,8 years. In one patient nonfunctional cyst was represented with cervical and upper mediastinal mass with maximal diameter of 10 cm. Conclusion. Although parathyroid cysts represent around 0.5% of all parathyroid pathology it should be considered as preoperative diagnose especially if water like liquid is found with fine needle aspiration biopsy. Experience endocrine surgeon should perform operation with preserving cysts wall to avoid parathyreomatosis, and recurrent laryngeal nerve preserving.