Benign Intratracheal Thyroid: A Systematic Review of 43 Cases With Five New Case Reports

Abstract

Objective/Hypothesis To examine the clinical features of benign intratracheal thyroid (ITT) and their management strategies and outcomes. Study Design Case series study. Methods This systemic review was conducted in two international academic centers. This review includes 43 patients: one new case from the Massachusetts Eye and Ear Infirmary, four new cases from Beijing Tongren Hospital, and 38 previously published cases. We analyzed these 43 cases and summarized the patients' epidemiological data, clinical features, and treatment regimens. Results ITTs were less common in men than in women (male:female ratio of 3:10). ITT was observed in patients as young as neonates and as old as 85 years. Orthotopic thyroid nodules were present in 55.8% of the patients with ITT. Malignancy was incidentally found in 4.6% of all ITTs. Imaging examinations showed that the ITTs were typically attached to the posterolateral/lateral tracheal wall of the first, second, or third tracheal rings. Tissue attachment between the ITT and normal thyroid lobes was seen in 59.5% of the patients. Thirty‐seven patients underwent surgery: 30 underwent open surgery, and seven underwent endoscopic debulking resections. One neonate received thyroid suppression therapy. One patient with ITT and papillary thyroid cancer was treated with radiotherapy and ultimately died after recurrence. Conclusions Surgical resection is an effective treatment for benign ITT. We hypothesized that abnormalities during the embryonic development of Berry's ligament might play a role in ITT pathogenesis. Level of Evidence NA Laryngoscope, 131:E2609–E2617, 2021

Ectopic thyroid carcinoma in central airway with normally located goiterous thyroid gland: A case report

“…Cases about benign intracheal thyroid presenting with Progressive dyspnea, cough, Bronchial asthma and incidental nding by autopsy have been reported [7]. Furthermore, this is the second case about malignant central airway obstruction caused by primary thyroid carcinoma in ETT.…”

“…The most commonly reported location is at the base of the tongue. Less than 10% of cases are found in peripheral sites, including cardiac, aortic and pulmonary, esophageal, duodenal, gallbladder, gastric, pancreatic and so on [3][4][5][6][7][8][9][10]. Evidence shows that the incidence of ETT have malignant potential is only < 1% [3], which is more commonly happened in young women [4].…”

“…Evidence shows that the incidence of ETT have malignant potential is only < 1% [3], which is more commonly happened in young women [4]. Cases of ectopic intratracheal thyroid presenting with stridor, bronchial asthma or no symptoms proved to be benign have been reported [5,6,7]. To our knowledge, nearly few reports of primary ectopic thyroid carcinoma in the central airway with a normal eutopic thyroid gland have been published to date [8][9][10][11][12][13][14][15][16].…”

The clinicopathological features, treatment outcomes and follow-up results of 47 ectopic thyroid gland cases: a single-center retrospective study

“…For example, patients with tracheal ETG may experience dyspnea and hemoptysis. The thoracic ETG may cause dysphagia and superior vena cava syndrome, while abdominopelvic organ ETG may cause bleeding, abdominal pain, and obstructive jaundice (28)(29)(30)(31)(32). Although most ETGs are benign and asymptomatic, the associated symptoms and the possibility of cancer should not be ignored.…”

“…It is vital to note that ETG is easily misdiagnosed as lingual root cysts and thyroglossal duct cysts. Therefore, carefully distinguishing these conditions from others is crucial to minimize diagnostic errors (11,28,37).…”