Airway management in patients with lingual thyroid: a case report and review of the literature

Nisa, Lluís; Morrison, Sarah; Levi, Eric

doi:10.1007/s00405-022-07310-0

Cited by 2 publications

(4 citation statements)

References 25 publications

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“…In the absence of a cervical thyroid gland, total removal of functional lingual thyroid tissue would result in hypothyroidism. Lifelong thyroid hormone replacement may be avoidable in initially functioning patients undergoing reimplantation of ectopic thyroid glands[ 13 ]. Therefore, transposition of lingual thyroid tissue should be considered to preserve thyroid function.…”

Section: Discussionmentioning

confidence: 99%

Transposition of the lingual thyroid gland to the submandibular region through a submandibular approach: A case report

Yin,

Gui

2024

World J Clin Cases

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BACKGROUND Ectopic thyroid at the base of the tongue is a rare congenital condition, and it is even rarer to have clinical symptoms and require surgical intervention. This disease is easily misdiagnosed preoperatively. This article reports the diagnosis, surgical treatment, and follow-up of a case of lingual thyroid. CASE SUMMARY The patient was a 54-year-old woman who presented with laryngeal foreign body sensation and dysphagia for 20 d. The lingual thyroid was considered for general examination, and surgery was performed to transpose the lingual thyroid to the right submaxillary region. Pathological analysis confirmed thyroid tissue. The patient experienced complete remission after surgery, but developed hypothyroidism and required thyroid hormone replacement therapy, and her thyroid function gradually recovered over time. CONCLUSION We report a rare case of lingual thyroid with marked laryngeal foreign body sensation and dysphagia. Symptoms were completely relieved by transposition surgery but postoperative hypothyroidism developed.

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Section: Discussionmentioning

confidence: 99%

Transposition of the lingual thyroid gland to the submandibular region through a submandibular approach: A case report

Yin,

Gui

2024

World J Clin Cases

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“…The second most important imagery tool was represented by the functional imaging of the thyroid tissue. If an EMT was suspected, this tissue was targeted using whole-body (not just cervical) scintigraphy; tracers such as 99m-Tc, 131 or 123 iodine play a pivotal role despite variations of radioiodine uptake in ectopic tissues [6,42]. Sometimes, the metabolic rate in ectopic thyroid tissue is different from the eutopic gland, and thus the diagnosis might be missed [13,169,170].…”

Section: Imaging Features In Emts 241 Ct Scanmentioning

confidence: 99%

“…Awareness remains the key operative element since the clinical index of suspicion is rather low, especially in non-cervical areas. Hence, currently, ectopic thyroid tissue remains a matter of individualized management [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Surgical resection of EMTs Surgery candidates mostly belong to one of these six categories: (1) suspected malignancy in EMTs (a rate of 18.8% was found); (2) compression symptoms (depending on anatomical effects and clinical features); (3) at-risk traits at imagery scans (e.g., necrosis, hemorrhage, increasing dimensions during follow-up); (4) lack of biopsy or FNA data (either they were not available, or they were non-diagnostic or the patient declined it, or they are too risky to be performed due to vessels' proximity or due to the general health status of one patient and co-morbidities); (5) prior or synchronous non-thyroid cancers whereas the presence of a mediastinal metastasis might change the entire case management; (6) prior or synchronous thyroid cancer in the eutopic gland whereas surveillance based on serum thyroglobulin and whole body iodine scintigraphy cannot be adequately used due to the presence of the ectopic tissue. The type of surgical procedure is based on the decision of a highly skilled team of cardiothoracic surgery.…”

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confidence: 99%

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Personalized Management of Malignant and Non-Malignant Ectopic Mediastinal Thyroid: A Proposed 10-Item Algorithm Approach

Carsote,

Ciobica,

Sima

et al. 2024

Cancers

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We aimed to analyze the management of the ectopic mediastinal thyroid (EMT) with respect to EMT-related cancer and non-malignant findings related to the pathological report, clinical presentation, imaging traits, endocrine profile, connective tissue to the cervical (eutopic) thyroid gland, biopsy or fine needle aspiration (FNA) results, surgical techniques and post-operatory outcome. This was a comprehensive review based on revising any type of freely PubMed-accessible English, full-length original papers including the keywords “ectopic thyroid” and “mediastinum” from inception until March 2024. We included 89 original articles that specified EMTs data. We classified them into four main groups: (I) studies/case series (n = 10; N = 36 EMT patients); (II) malignant EMTs (N = 22 subjects; except for one newborn with immature teratoma in the EMT, only adults were reported; mean age of 62.94 years; ranges: 34 to 90 years; female to male ratio of 0.9). Histological analysis in adults showed the following: papillary (N = 11/21); follicular variant of the papillary type (N = 2/21); Hürthle cell thyroid follicular malignancy (N = 1/21); poorly differentiated (N = 1/21); anaplastic (N = 2/21); medullary (N = 1/21); lymphoma (N = 2/21); and MALT (mucosa-associated lymphoid tissue) (N = 1/21); (III) benign EMTs with no thyroid anomalies (N = 37 subjects; mean age of 56.32 years; ranges: 30 to 80 years; female to male ratio of 1.8); (IV) benign EMTs with thyroid anomalies (N = 23; female to male ratio of 5.6; average age of 52.1 years). This panel involved clinical/subclinical hypothyroidism (iatrogenic, congenital, thyroiditis-induced, and transitory type upon EMT removal); thyrotoxicosis (including autonomous activity in EMTs that suppressed eutopic gland); autoimmune thyroiditis/Graves’s disease; nodules/multinodular goiter and cancer in eutopic thyroid or prior thyroidectomy (before EMT detection). We propose a 10-item algorithm that might help navigate through the EMT domain. To conclude, across this focused-sample analysis (to our knowledge, the largest of its kind) of EMTs, the EMT clinical index of suspicion remains low; a higher rate of cancer is reported than prior data (18.8%), incident imagery-based detection was found in 10–14% of the EMTs; surgery offered an overall good outcome. A wide range of imagery, biopsy/FNA and surgical procedures is part of an otherwise complex personalized management.

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Airway management in patients with lingual thyroid: a case report and review of the literature

Cited by 2 publications

References 25 publications

Transposition of the lingual thyroid gland to the submandibular region through a submandibular approach: A case report

Transposition of the lingual thyroid gland to the submandibular region through a submandibular approach: A case report

Personalized Management of Malignant and Non-Malignant Ectopic Mediastinal Thyroid: A Proposed 10-Item Algorithm Approach

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