Ectopic intrapulmonary follicular adenoma diagnosed by surgical resection

Sumiya, Ryusuke; Sekihara, Keigo; Sugimura, Aya; Miyazaki, Hideki T.; Igari, Toru; Ikeda, Takeshi; Nagasaka, Satoshi

doi:10.1007/s11748-020-01485-1

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…However, the sensitivity of fine-needle aspiration cytology in identifying the properties of nodules is approximately 90%, and there are certain diagnostic errors [ 13 , 14 ]. Thoracoscopic resection and biopsy of pulmonary nodules can be used to not only explore the shape and nature of multiple pulmonary nodules but also to completely remove single or multiple pulmonary nodules and sample enough tissue to make a definitive diagnosis [ 15 ]. Because the accuracy of thoracoscopic biopsy is approximately 100%, thoracoscopic resection biopsy is more accurate than fine-needle aspiration cytology of lung nodules [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Rare ectopic thyroid tissue as multiple bilateral pulmonary nodules: a case report and literature review

Tan

Kuang

et al. 2022

J Cardiothorac Surg

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Background The prevalence of ectopic thyroid tissue is 1 in every 100,000 to 300,000 persons in the general population, and ectopic thyroid tissue in the bilateral lung lobes is even rarer. Due to its rarity, there is no definitive or standard guidance on the diagnosis and treatment of ectopic thyroid tissue presenting as multiple bilateral pulmonary nodules. Case presentation A 56-year-old woman presented with multiple bilateral pulmonary nodules, and the patient had a history of hyperthyroidism but had no symptoms of ectopic thyroid tissue. Computed tomography (CT) demonstrated multiple solid nodules in both lungs, and the largest nodule (sized 15 × 14 mm) was located in segment 5 of the upper left lung. The initial diagnosis based on imaging was metastatic malignancies. Positron emission tomography-computed tomography (PET-CT) showed multiple bilateral intrapulmonary nodules that had slightly increased metabolism (SUVmax 1.7). The largest pulmonary nodule and another nodule in the left lung were resected by video-assisted thoracoscopy surgery (VATS). The pathological and immunohistochemical (IHC) examinations confirmed a diagnosis of ectopic thyroid tissue. No postoperative adjuvant therapy was given, and the patient was discharged 3 days after the operation and had regular follow-up examinations. Conclusion The diagnosis of ectopic thyroid tissue in the bilateral lung lobes is extremely difficult and should be considered carefully. PET-CT and surgical resection of intrapulmonary nodules are alternatives for clinicians in diagnosing ectopic thyroid tissue. Regular postoperative follow-up is needed.

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Section: Discussionmentioning

confidence: 99%

Rare ectopic thyroid tissue as multiple bilateral pulmonary nodules: a case report and literature review

Tan

Kuang

et al. 2022

J Cardiothorac Surg

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show abstract

“…However, the sensitivity of ne needle aspiration cytology in identifying the properties of nodules is approximately 90%, and there were certain diagnostic errors [13,14]. Thoracoscopic resection and biopsy of pulmonary nodules can not only explore the shape and nature of multiple pulmonary nodules but also can be used to completely remove single or multiple pulmonary nodules and to obtain enough tissue samples to make a de nite diagnosis [15]. Thoracoscopic resection biopsy is more accurate than ne-needle aspiration cytology of lung nodules.…”

Section: Discussionmentioning

confidence: 99%

Rare ectopic thyroid as bilateral multiple pulmonary nodules: a case report and literature review

Tan

Kuang

et al. 2022

Preprint

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Background: The prevalence of ectopic thyroid tissue is 1 in every 100,000 to 300,000 persons in the general population, and ectopic thyroid in the bilateral lung lobes is even rarer. Due to its rarity, there is no definitive or standard guidance on the diagnosis and treatment of ectopic thyroid tissue presenting as bilateral multiple pulmonary nodules.Case presentation: A 56-year-old woman presented with multiple pulmonary nodules in her lung lobes bilaterally, and the patient had a history of hyperthyroidism but had no symptoms of ectopic thyroid tissue. Computed tomography (CT) demonstrated multiple solid nodules in both lungs, and the largest nodule (sized 15 x 14 mm) was located in segment 5 of the upper-left lung. The initial diagnosis based on imaging was metastatic malignancies. Positron emission tomography-computed tomography (PET-CT) showed multiple intrapulmonary nodules in the lung lobes bilaterally that had slightly increased metabolism (SUVmax 1.7). The largest pulmonary nodule and another nodule in the left lung were resected by video-assisted thoracoscopy surgery (VATS). The pathological and immunohistochemical (IHC) examinations confirmed a diagnosis of ectopic thyroid tissue. No postoperative adjuvant therapy was given, and the patient was discharged 3 days after the operation and had regular follow-up examinations.Conclusion: The diagnosis of ectopic thyroid tissue in the lung lobes bilaterally is excessively difficult and should be considered carefully. PET-CT and surgical resection of the intrapulmonary nodule are new options for clinicians to diagnose ectopic thyroid tissue. Regular follow-up is needed postoperatively.

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“…The mediastinal location may be easily explained by the local attachment of the primordial thyroid at this site before starting its caudal migration [8,26]. Alternatively, ectopic thyroid tissue at the level of the anterior mediastinum, lung [27], heart, and pericardium may have been dragged into the chest together with the heart and its great vessels amid physiological embryogenesis [11,28,29]. Of note, carcinoma showing thymus-like differentiation (CASTLE) of the thyroid might also be found in the mediastinum in addition to EMTs and retrosternal goiter [30].…”

Section: The Issue Of Ectopic Thyroid Tissuementioning

confidence: 99%

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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Ectopic intrapulmonary follicular adenoma diagnosed by surgical resection

Cited by 3 publications

References 14 publications

Rare ectopic thyroid tissue as multiple bilateral pulmonary nodules: a case report and literature review

Rare ectopic thyroid tissue as multiple bilateral pulmonary nodules: a case report and literature review

Rare ectopic thyroid as bilateral multiple pulmonary nodules: a case report and literature review

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

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