Papillary Carcinoma in a Lingual Thyroid: An Unusual                     Presentation

Bhojwani, Kiran M; Hegde, Mahesh Chandra; Alva, Arathi; Kadam, Vishwas D

doi:10.1177/014556131209100708

Cited by 8 publications

(10 citation statements)

References 10 publications

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“…On plain CT, ectopic thyroid tissue usually displays higher density than the surrounding soft tissue, [ 3 ] but 1 case in the present study was not obvious. Although enhanced CT demonstrated ectopic thyroid tissue more clearly than plain CT, [ 22 ] some cases in the present study and in the literature [ 16 ] suggest that enhanced CT is still not reliable. On MRI, Takashima et al [ 23 ] reported that ectopic thyroid appears isointense or hyperintense relative to muscle tissue on T1WI and hyperintense on T2WI, which was also observed in the present study.…”

Section: Discussioncontrasting

confidence: 54%

The value of scintigraphy, computed tomography, magnetic resonance imaging, and single-photon emission computed tomography/computed tomography for the diagnosis of ectopic thyroid in the head and neck

Xu¹,

Yang

Gu³

et al. 2018

Medicine

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Because of its rarity, the exact imaging features of ectopic thyroid are poorly known.To analyze the value of scintigraphy, computed tomography (CT), magnetic resonance imaging (MRI), and single-photon emission computed tomography (SPECT)/CT in the diagnosis of ectopic thyroid in the head and neck.First, we retrospectively analyzed the scintigraphy, CT, MRI, and SPECT/CT images from 25 masses (22 patients) suspected of head and neck ectopic thyroid from 2006 to 2017 at the Shanghai Ninth People's Hospital. Each mass was imaged by nuclear imaging (scintigraphy with or without SPECT/CT) and radiological exam (CT and/or MRI). Pathological examination was considered as the gold standard. Secondly, thirteen malignant ectopic thyroids in the head and neck reported in the English literature from 2001 to 2017 were retrieved for comparison.The accuracy of scintigraphy was not significantly higher than that of CT (94.7%, vs 89.5%, P > .99) or MRI (92.3%, vs 84.6%, P > .99). Five masses which underwent scintigraphy with SPECT/CT were all true positive, while 1 was false negative on MRI, and 2 were false negative on CT. Compared to the benign ectopic thyroids in our study, the 13 malignant ectopic thyroids retrieved from the literature were grossly the same in shape, margins, and invasion on CT or MRI.The number of patients was limited, but scintigraphy combined with SPECT/CT could be a reliable method for the diagnosis of ectopic thyroid. Benign and malignant ectopic thyroids appear to be similar in shapes, margins, and invasion on CT or MRI.

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Section: Discussioncontrasting

confidence: 54%

The value of scintigraphy, computed tomography, magnetic resonance imaging, and single-photon emission computed tomography/computed tomography for the diagnosis of ectopic thyroid in the head and neck

Xu¹,

Yang

Gu³

et al. 2018

Medicine

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“…The prevalence of ectopic thyroid is approximately 1 per 100,000–300,000 people [ 3 ]. One major clinical concern regarding ectopic thyroid glands is their potential risk for malignant transformation [ 4 , 5 ]. Functional abnormalities associated with ectopic thyroid have also been well recognized.…”

Section: Introductionmentioning

confidence: 99%

New insight into ectopic thyroid glands between the neck and maxillofacial region from a 42-case study

Jiang

Wang

et al. 2015

BMC Endocr Disord

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BackgroundEctopic thyroid is a rare disease. In the present study at the 9th People’s Hospital in Shanghai, China, 42 patients’ ectopic thyroid glands between the neck and maxillofacial region were subjected to a retrospective and transverse study based on data from 1978 to 2012 to explore the natural characteristics of ectopic thyroid.MethodsThe patients’ clinical data were collected. In addition, scintigraphy (Tc-99 m, Iodine-131), CT scan, histology and pathology were performed. The protein expression of thyroid transcription factor-1 (TTF-1), thyroglobulin (TG), calcitonin (CT), Ki-67 and parathyroid hormone (PTH) were analyzed from paraffin wax-stored specimens of ectopic thyroid tissue compared with those of orthotopic thyroid tissue.ResultsThere were 42 total ectopic thyroid patients, approximately 1.24 patients per year on average at our hospital. These patients were aged from 6 to 85 years old, and there were 35 females (83.3 %), seven males (16.7 %). In total, 27 of the patients had lingual thyroid (64 %); seven, sublingual thyroid (17 %); five, dual areas occupied by ectopic thyroid (12 %) and three, other types (7 %). The following conditions were also presented: nodular goiter (13 %), adenoma (8.7 %) and Hashimoto’s thyroiditis (4.3 %), no malignancy and no accompanying ectopic parathyroid. TTF-1 expression was significantly higher in ectopic samples than that in orthotopic samples (P = 0.007), but CT and Ki-67 levels displayed no difference. PTH was negative in ectopic tissue.ConclusionEctopic thyroid is a rare disease and females were more prone to the disease. The most frequent location was lingual thyroid. Nodular goiter, adenoma and Hashimoto’s thyroiditis was observed as orthotopic thyroid without accompanying ectopic parathyroid. TTF-1 was highly expressed in ectopic tissue, which may be related to abnormal embryogenesis leading to the thyroid gland being in an abnormal position. The expression of calcitonin (CT) and Ki-67 was not increased, and there were no malignant cells in any sample, which could indicate that it is not easy for ectopic thyroids to become malignant between the neck and maxillofacial region.

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“…Surgical treatment should be considered in situations where medical management fails, if there is suspicion of malignancy, with obstructive symptoms or according to patient preference. There are various types of surgical approaches for lingual thyroidectomy including transoral approach with medial incision of the tongue, lateral pharyngotomy and mandibular osteotomy of the midline which, at this time, would actually be the last option only if lateral pharyngotomy is considered to be ideal for the transposition of the lingual thyroid to the lateral wall of the pharynx 2,3,5,6,10,11 .…”

Section: Discussionmentioning

confidence: 99%

“…Thirty-three per cent of patients with lingual thyroid have hypothyroidism, and 70% of patients have thyroid tissue only at the lingual level. Risk of malignant transformation is uncommon (1%), the same as presented in orthotopic thyroid tissue, and the most frequent histology is the follicular variant [2][3][4] . We present an additional case of lingual thyroid with clinical symptoms and discuss diagnosis and treatment approach.…”

Section: Introductionmentioning

confidence: 99%

Laser resection of lingual thyroid gland

et al. 2014

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Lingual thyroid is a rare condition resulting in an abnormal development during its descent from the foramen cecum. Most cases are asymptomatic, and only 0.01% of cases will present with obstructive symptoms. We present a case of lingual thyroid in a 33-year-old woman with clinical symptoms of foreign body sensation. Lingual thyroid was diagnosed using magnetic resonance imaging and 99m Tc thyroid scan. Resection was decided upon using a transoral approach with O2 laser. Definitive diagnosis was established of lingual thyroid with colloid goiter. The patient had an uneventful post-operative course and was discharged at 24 h. The patient is being followed up with hormonal treatment. Management of this condition remains controversial. We discuss the diagnostic approach and therapeutic alternatives. bs_bs_banner Oral Surgery ISSN 1752-2471 7 Oral Surgery 7(S1) (2014) 7-10. Luna-Ortiz et al. Lingual thyroid 9Oral Surgery 7(S1) (2014) 7-10.

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Papillary Carcinoma in a Lingual Thyroid: An Unusual Presentation

Cited by 8 publications

References 10 publications

The value of scintigraphy, computed tomography, magnetic resonance imaging, and single-photon emission computed tomography/computed tomography for the diagnosis of ectopic thyroid in the head and neck

The value of scintigraphy, computed tomography, magnetic resonance imaging, and single-photon emission computed tomography/computed tomography for the diagnosis of ectopic thyroid in the head and neck

New insight into ectopic thyroid glands between the neck and maxillofacial region from a 42-case study

Laser resection of lingual thyroid gland

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