Enlarged hemorrhagic lingual thyroid managed with transoral robotic surgery

Filarski, Carolyn F.; Levine, Brett R.; Buttan, Anshu; Gonzalez, Nestor R.; Ho, Allen S.

doi:10.1007/s12020-020-02586-w

Cited by 3 publications

(2 citation statements)

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“…В момент диагностики функция ЩЖ может быть как сохранена, так и снижена [25][26][27]. В редких случаях могут появиться такие симптомы, как затруднение глотания, ощущение инородного тела, кашель, изменение голоса, храп, апноэ во сне, а в более тяжелых случаях -кровотечение и обструкция дыхательных путей [28][29][30][31][32][33][34][35]. Выраженность клинической картины зависит от размера и локализации эктопированной тиреоидной ткани.…”

Section: обоснованиеunclassified

“…В первом случае эктопия выявлена при осмотре педиатром после перенесенной ангины, во втором -единственным клиническим проявлением был периодический кашель, в третьем -объемное образование проявлялось дисфагией и кашлем. Аналогичные клинические проявления, связанные с эктопически расположенной тиреоидной тканью, согласуются с литературными данными и зависят от объема эктопированной ткани [28][29][30][31][32][33][34]43]. У остальных 22 детей с эктопией ЩЖ в корень языка диагноз был установлен по результатам неонатального скрининга, клинических проявлений (кашля, дисфагии) не отмечалось.…”

Section: результатыunclassified

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Ectopic thyroid gland: clinical features and diagnostics in children

Shreder

Vadina

Konyukhova³

et al. 2022

Probl Endokrinol (Mosk)

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BACKGROUND: The frequency of ectopia of thyroid gland among all types of dysgenesis varies from 30 to 70%, its most common localization is the root of the tongue. Otorhinolaryngologists, oncologists, pediatricians can take lingual ectopia for hypertrophy of the lingual tonsil or fibroma of the tongue root, which leads to unreasonable surgical treatment. Thyroid scintigraphy plays a key role in the diagnosis of ectopia.AIM: To assess the etiological structure of congenital hypothyroidism (CH) and demonstrate the clinical course in patients with ectopic thyroid tissue in the root of the tongue.MATERIALS AND METHODS: A group of patients with CH was examined. All patients underwent neck ultrasound and radionuclide imaging. The examination was carried out against the background of the abolition of hormone replacement therapy for 14 days or before its initiation. Patients with ectopia in the root of the tongue underwent videofibrolaryngoscopy. Some patients underwent a genetic study with using genes panel of a panel of candidate genes responsible for the development of CH using the NGS method. The molecular genetic study was conducted to some patients, next-generation sequencing with the genes panel.RESULTS: The study included 73 patients with primary CH aged from 2 weeks to 17.3 years: 69 children were diagnosed based on the results of neonatal screening, 4 children with thyroid ectopia were first examined older than 6 years. The median age of patients at the time of the examination was 6.9 years [4.8; 10.0]. By data of ultrasound aplasia was diagnosed in 47.9% of patients, one child had hemiagenesis and ectopic thyroid tissue of various localization was detected in 26.0% of children. In 24.7% of children thyroid tissue was found in a typical location. Scintigraphy confirmed thyroid aplasia in 65.7% of children. Examination revealed various variants of ectopically located thyroid tissue in 31 children (42.4%): thyroid ectopia in the root of the tongue in 25 children (80.6%), ectopia in the sublingual region in 5 children (16.2%), double ectopia was detected in 1 child. The median level of TSH in newborns with ectopic thyroid gland was 124 IU/ml and was significantly lower than in children with aplasia — 219 IU/ml, p<0.05. On the other side the level of TG in children with ectopia was significantly higher than in children with aplasia — 37.12 ng/ml versus 0.82 ng/ml, p><0.05. CONCLUSION: Combination of two methods is the best diagnostic approach to determine the etiology of CH — ultrasound and scintigraphy studies compensates deficiencies of each other. Our study demonstrates the importance of scintigraphy in children with CH and patients with the formation of the root of the tongue and the anterior surface of the neck in order to avoid unnecessary removal of the thyroid gland. In case of confirmation of thyroid ectopia in the root of the tongue and in the absence of symptoms of obstruction or bleeding, it is recommended to refer the patient to an endocrinologist for conservative treatment. ><0.05. On the other side the level of TG in children with ectopia was significantly higher than in children with aplasia — 37.12 ng/ml versus 0.82 ng/ml, p< 0.05.CONCLUSION: Combination of two methods is the best diagnostic approach to determine the etiology of CH — ultrasound and scintigraphy studies compensates deficiencies of each other. Our study demonstrates the importance of scintigraphy in children with CH and patients with the formation of the root of the tongue and the anterior surface of the neck in order to avoid unnecessary removal of the thyroid gland. In case of confirmation of thyroid ectopia in the root of the tongue and in the absence of symptoms of obstruction or bleeding, it is recommended to refer the patient to an endocrinologist for conservative treatment.

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