Hemiagenesis of the thyroid gland detected by coincidence—what is the clinical relevance?

Mikosch, Peter; Weixlbaumer, Verena; Irrgang, Michael; Aistleitner, Adrian; Trifina-Mikosch, Eva

doi:10.1007/s10354-020-00783-w

Cited by 8 publications

(11 citation statements)

References 43 publications

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“…THA is a rare congenital anomaly of the thyroid gland with about 800 cases reported in the literature until 2020 [5]. The true prevalence of THA is not clearly known, with the reported prevalence rates varying between 0.05 to 0.5 % [1].…”

Section: Discussionmentioning

confidence: 99%

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Thyroid hemiagenesis with a TI-RADS 2 nodule in the contralateral lobe

2021

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Background Thyroid hemiagenesis is a rare congenital anomaly in which one lobe of the thyroid gland fails to develop. There is an increased incidence of associated thyroid disorders in patients with thyroid hemiagenesis. Case presentation A 32-year-old Ugandan woman presented with a complaint of painless neck swelling of 3-months duration. The swelling was associated with a globus sensation. There was no history of thyroid – related problems or treatment prior to this presentation. Physical examination demonstrated a mobile right thyroid swelling without an obvious nodular contour. Neck ultrasound showed an absent left lobe of thyroid gland, a right lobe with a solitary nodule scoring two points on the Thyroid Imaging, Reporting and Data System (TI-RADS) and an isthmus in situ. Extensive search for possible ectopic thyroid tissue was negative. She was biochemically euthyroid. The patient was counseled about thyroid hemiagenesis and was put on a regular follow up in the clinic for the TI-RADS 2 nodule. Conclusion Thyroid hemiagenesis is often associated with other thyroid disorders. Its diagnosis should prompt an active search for other associated morphological or functional thyroid abnormalities.

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Section: Discussionmentioning

confidence: 99%

“…However, the etiology still remains unclear [4]. Genetic aberrations may have a role in the etiology of this disorder, as reported in monozygotic twin studies [5].…”

Section: Introductionmentioning

confidence: 99%

Thyroid hemiagenesis with a TI-RADS 2 nodule in the contralateral lobe

2021

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“…Following ultrasound, thyroid scintigraphy using technetium or iodine detects the functional anatomy of the thyroid gland with the added advantage of being able to detect the presence of hyperactivity and increased diffuse uptake in the glands [ 36 ]. Furthermore, scintigraphy can be used to detect ectopic thyroid tissue as well as diagnose thyroid pathologies in the remaining lobe associated with hyperthyroidism or a nodule suspicious of cancer [ 3 ]. The disadvantage of scintigraphy is due to artifacts related to the inability to view a thyroid lobe due to cancer, a contralateral autonomous solitary thyroid nodule suppressing normal tissue function, inflammatory and infiltrative pathologies of the thyroid gland, also the use of computed tomography scans have been helpful in further establishing the diagnosis.…”

Section: Reviewmentioning

confidence: 99%

“…Anomalies in their development can lead to abnormalities in the structure or function of which THA is a part [ 2 ]. Genetic abnormalities may have a role to play in the etiology of THA as reported in monozygotic twins [ 3 ]. Different studies have shown that in 80% of cases, it affects the left lobe with an L:R ratio of 4:1.…”

Section: Introductionmentioning

confidence: 99%

Thyroid Hemiagenesis: Narrative Review and Clinical Implications

Lesi¹,

Thapar²,

Appaiah³

et al. 2022

Cureus

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Thyroid Hemiagenesis (THA) is an uncommon, congenital anomaly defined by the absence of one thyroid lobe with or without the isthmus. Reports suggest it may be found more often in regions endemic for hypothyroidism. Genetic abnormalities are thought to have a role based on findings in monozygotic twins. Most cases are sporadic, however familiar clusters have also been documented. It is found more frequently in females. A majority of patients report no symptoms and THA is found incidentally during investigations or intraoperatively. THA is usually associated with normal thyroid function, but it can present with thyroid hypofunction.Since a majority of patients are asymptomatic, there are no specific recommendations for management. Ultrasound imaging and thyroid scintigraphy using technetium or iodine are useful in diagnosis. Its clinical importance occurs when the remnant thyroid lobe requires excision leading to the lifelong requirement for thyroxine supplementation.Published English literature (Medline, PubMed, and Embase databases) was searched. Medical subject headings (MeSH) terms used were "thyroid hemiagenesis," "one thyroid lobe," and "thyroid aplasia". Case reports, case series, and original articles were selected to provide a framework for this review.Articles reviewed were published in the past 20 years. The association of THA with thyroid cancer was explored. In this group, the F:M ratio was 3.25:1. Left THA constituted 53% of cases, right THA in 29.4%, and isthmus absence in 17.6% of cases. Also, the authors investigated the link between THA and hyperparathyroidism, both left and right THA are seen in an equal number of cases in the hyperparathyroidism subgroup. In patients with THA and Grave's disease, left THA was seen in a majority of cases (86.7%), while an equal number of left and right THA was observed in patients with Hashimoto's thyroiditis. In addition, congenital abnormalities associated with THA were observed, the left THA was seen in 60% and right THA in 40% of cases of this subgroup.The summative review provided a detailed insight into the epidemiology, aetiopathogenesis, genetics, symptomatology, diagnosis, and treatment for THA by combining findings and results from almost a hundred research papers from around the world. THA remains a poorly understood, often incidentally detected, abnormality in euthyroid patients undergoing investigations and treatment for other thyroid disorders.

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“…To date, a few previous reports described the imaging findings of thyroid hemiagenesis as absence of the one thyroid lobe in scintigraphy, ultrasonography (US), and computed tomography (CT) [ 7 – 10 ]. However, absence of one thyroid lobe in imaging study may strongly suggest the diagnosis of hemithyroidectomy state in patients for whom no or little clinical information is available.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography findings of thyroid hemiagenesis: differentiation from hemithyroidectomy

et al. 2023

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Objectives Thyroid hemiagenesis is a rare congenital anomaly characterized by the lack of development of one thyroid lobe. The purpose of this study was to evaluate computed tomography (CT) findings of thyroid hemiagenesis and to establish useful CT criteria for differentiating thyroid hemiagenesis from the hemithyroidectomy state. Methods The CT images of 11 patients with thyroid hemiagenesis were retrospectively reviewed and compared with those of 100 (49 left and 51 right) patients in a hemithyroidectomy state. Image analysis was performed according to the following CT parameters: (a) side of thyroid hemiagenesis, (b) edge of the medial end of the remnant thyroid gland, (c) location of the medial end of the remnant thyroid gland, expressed as the angle of the medial end and (d) any other thyroid abnormality observed during the initial examination. Results The missing lobe occurred more often in the left than in the right lobe (72.7% vs. 27.3%) as well as concomitant isthmus agenesis (100% vs. 37.5%). The sharp edge of the medial end of the remnant thyroid gland was more common in thyroid hemiagenesis (64%) than in hemithyroidectomy (26%) (P = 0.0153). In left thyroid hemiagenesis, the angle of the medial end (63%) was more frequently > + 30° than in hemithyroidectomy (0%) (P < 0.0001). Two patients presented with hypothyroidism; the remaining nine showed a normal thyroid function. The associated thyroid diseases were autoimmune thyroiditis (n = 1) and papillary thyroid carcinoma (n = 1). Conclusions The sharp edge of the medial end of the remnant thyroid gland and an angle of > + 30° for the medial end in cases wherein the left lobe is absent are useful CT features for distinguishing thyroid hemiagenesis from hemithyroidectomy.

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Hemiagenesis of the thyroid gland detected by coincidence—what is the clinical relevance?

Cited by 8 publications

References 43 publications

Thyroid hemiagenesis with a TI-RADS 2 nodule in the contralateral lobe

Thyroid hemiagenesis with a TI-RADS 2 nodule in the contralateral lobe

Thyroid Hemiagenesis: Narrative Review and Clinical Implications

Computed tomography findings of thyroid hemiagenesis: differentiation from hemithyroidectomy

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