Thyroid Hemiagenesis with Multinodular Goiter: A Case Report and Review of the Literature

Abstract

Abstract. Thyroid hemiagenesis is a very rare abnormality, in which one thyroid lobe fails to develop. Most of the patients diagnosed have an associated thyroidal disease. The true prevalence of thyroid hemiagenesis is not known, but it is estimated to be 0.02% in normal children. We report a forty-five year-old female patient with a multinodular goiter in left lobe, associated with hemiagenesis of right lobe and isthmus. CaseA 45-year-old female patient was presented with long-standing, painless, palpable left thyroid mass. She was clinically euthyroid, and had a palpable left lobe (Grade 1b) associated with probable 2 cm thyroid nodule in the lower pole of the left lobe. The rest of the physical examination was unremarkable. Her serum free T3, free T4, TSH, antithyroglobulin antibody, antimicrosomal antibody levels were 2.5 pg/ml (normal range: 2.3-4.2), 1.3 ng/ml (normal range: 0.8-1.5), 0.89 mIU/ml (normal range: 0.5-5.5), 20 IU/ml (normal range: 0-50), and 19 IU/ml (normal range: 0-50) respectively. As shown in Fig. 1, thyroid scintigraphy with Tc-99 m pertechnetate revealed the absence of right lobe and isthmus and a hypoactive nodule in the lower pole of left lobe. Ultrasonography confirmed the right lobe and the isthmus agenesis (Fig. 2). Ultrasonography revealed a left lobe (25 × 22 × 67 mm) with multiple nodules (Fig. 3). The dominant nodule was a degenerated cystic nodule in the lower pole of left lobe (20 × 22 × 25 mm). Fine needle aspiration biopsy revealed a degenerated colloidal nodule.

Thyroid hemiagenesis, Graves’ disease and differentiated thyroid cancer: a very rare association: case report and review of literature

“…1 The presence or absence of the isthmus is variable (50% of cases). 9 Currently, the prevalence of thyroid hemiagenesis is estimated to be from 0.025% to 0.16%, according to the literature, 9 and it seems to be higher in iodine-deficient areas.…”

Thyroid Hemiagenesis Presenting As Hypothyroidism – A Rare Case Report

“…The actual incidence of the hemiagenesis is unknown as most patients worldwide are admitted with a suspicion of other thyroid abnormalities like benign adenoma, multinodular goiter, hyper and hypothyroidism (as in our case) and hemiagenesis is seen as an incidental finding. [10][11][12][13] Thyroid agenesis should be suspected in all the cases where there is no palpable thyroid tissue felt on one or either side of the neck. Radiological investigations hold the key role in diagnosing this condition.…”

Thyroid Hemiagenesis: Report of a Case and Review of the Literature

“…The first case of hemithyroid agenesis was reported in 1866 [2]. To date approximately 300 cases have been reported worldwide in current literature [3]. We report a patient who presented to our service with a left neck mass and an incidental finding of a left thyroid lobe agenesis.…”

“…Thyroid hemiagenesis is a rare anomaly defined by the congenital absence of one of the thyroid lobes with an estimated prevalence rate of 0.02% [3]. The first case of hemithyroid agenesis was reported in 1866 [2].…”