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A pararectal mass' specific diagnosis can be challenging as a broad range of both benign and malignant tumors are possible. Many of these lesions are congenital and do not require treatment, if asymptomatic. Special attention is to be paid when imaging findings are not typical. In such cases, definitive diagnostic can require surgical excision. To this day, ectopic thyroid tissue was not part of known differential diagnosis. This is the first reported case of thyroid adenoma found in the perirectal area. Ectopic thyroid gland can progress over time and include malignant transformation, although rare. It needs to be considered when managing these cases, especially in unusual locations. This case report offers a systematic approach to the atypical pararectal tumor. It shares new specific clinical experience in managing a case  of pararectal ectopic thyroid adenoma, from both a surgical and a histopathological point of view. [ABSTRACT FROM AUTHOR]

Failure in the embryological development of the thyroid in adults is rarely seen. We present the case of a 79-year-old female patient who complained of dysphagia and progressive upper respiratory obstruction, which started 12 months prior to her admission. An ENT clinical exam revealed a tongue base, spherical, well-defined tumour covered by normal mucosa. Further assessments established the diagnosis of the tongue base ectopic thyroid tissue. Due to the patient's symptoms, a transhyoid tongue base tumour removal was performed. The selected patient gave consent for participation and inclusion in this paper, in compliance with the 1964 Helsinki declaration. [ABSTRACT FROM AUTHOR]

Nodal metastasis is crucial for determining the stage of well-differentiated thyroid cancer (WTC) in patients older than 55. Well-formed thyroid follicular inclusions (TFIs) are occasionally encountered in the cervical lymph nodes (LNs) of patients with papillary thyroid carcinoma (PTC), and it is difficult to determine whether they are true nodal metastases or ectopic thyroid tissues (ETT). This study aimed to elucidate the impact of the expression of the DNA damage response molecule TP53-binding protein 1 (53BP1) using immunofluorescence (IF) as a biomarker to differentiate TFIs in cervical LN by comparing the mutation analyses of primary thyroid cancers. The data demonstrated the necessity for the differential diagnosis of true metastases from ETT among TFIs in cervical LNs. PTC-like nuclear features using hematoxylin–eosin staining combined with immunohistochemistry for conventional biomarkers of PTC, including BRAFV600E protein, were most helpful in identifying metastatic follicular-patterned carcinomas. In conclusion, IF analysis of 53BP1 expression could be an excellent ancillary technique to distinguish metastatic carcinoma or ETT from TFIs in LNs, particularly in cases other than BRAFV600E-mutated PTC. [ABSTRACT FROM AUTHOR]

Background: Dual ectopic thyroid, a very rare condition, is defined as the simultaneous presence of ectopic thyroid tissue in two abnormal locations. Here, we report the surgical management of a patient with dual ectopic thyroid. Case presentation: The patient was a 12-year-old boy with right para-midline swelling for 2 months. On physical examination of the upper anterior neck, there was a 4 cm × 3 cm mass that was soft, mobile, smooth, and painless. Blood examination showed euthyroidism. Neck ultrasonography showed a well-circumscribed multilocular cyst. We followed up by observation only because the patient had no local symptoms or malignancy. After 2 years, the mass gradually enlarged, so we performed surgery to improve cosmetic outcomes. Preoperative neck CT revealed both a high-density solid mass at the base of the tongue and a central low-density region surrounded by a high-density area at the pretracheal region below the hyoid. The infrahyoid mass was surgically removed, and the sublingual mass was left intact. Pathological findings showed the growth of multiple-size follicles, leading to a diagnosis of adenomatous goiter. Postoperative 123−I scintigraphy showed radioactive iodine uptake in the sublingual lesion, but none in the normal thyroid bed despite the extirpation of thyroid tissue. Postoperative thyroid hormone replacement was started for subclinical hypothyroidism. One year postoperatively, the patient became euthyroid. Conclusion: Surgical excision was used to manage a symptomatic cervical infrahyoid mass related to dual ectopic thyroid. Postoperatively, thyroid hormone replacement was required both to prevent enlargement of the remaining sublingual thyroid and to maintain adequate thyroid hormone levels. [ABSTRACT FROM AUTHOR]

Patients diagnosed with Lingual thyroid (LT) may have second thyroid anomaly (STA).Given rarity of dual ectopics/anomalies, standardized management recommendations are lacking. We aimed to describe our experience in management of LT with STA and suggest a management algorithm. We conducted a retrospectivechart review of patients diagnosed with LT between Jul-2013 and Dec-2019. Data regarding demographics, clinical presentation, endocrine-profile, associated STA treatment received, and outcomes were collected and analyzed. Eight patients (female-7 cases, male-1 case, adult-4 cases, children-4 cases, mean age-18.1 years, range 6–43 years) with LT were identified. Four(50%) cases had STA in addition to LT (thyroglossal cyst in two-cases, sublingual thyroid in one-case and sub-mental thyroid in one-case) and presented as neck mass. Diagnosis was confirmed with flexible-nasopharyngoscopy,ultrasonography,thyroid-scintigraphy and computed-tomography. Ectopic thyroid(s) was/were only functional thyroid gland with absence of normal thyroid in all cases. Two- cases had symptomatic for LT and were managed by coblation assisted excision of LT in one and I131 ablation in one-case.All adult patients were hypothyroidand received thyroxin.All pediatric cases were euthyroidand received no surgical intervention for LT.Three patients required surgery for STA; Sistrunk surgery in two and excision of submental thyroid in one. All cases were asymptomatic. These results were utilized to suggest a management algorithm for LT with STA. LT patients with STA are more symptomatic and required more surgical interventions in compare to isolated LT. When appropriate, excision of STA with/without intervention for LT and thyroxin is advocated as the treatment modality of choice in LT patients with STA. [ABSTRACT FROM AUTHOR]

Concurrent thyroid hemiagenesis and ectopic thyroid tissue are rare conditions and can challenge the clinical appearance. Only one other case story in the literature has described thyroid hemiagenesis and concurrent submandibular ectopic thyroid tissue. A 29-year-old female with an asymptomatic submandibular mass was referred to our clinic. Based on clinical investigation and ultrasound-guided fine-needle aspiration, we were not able to determine whether the neck mass was a cystic metastasis or ectopic thyroid tissue. Magnetic Resonance Imaging showed hemiagenesis of the right thyroid lobe. The neck mass was surgically removed, and the histopathology revealed thyroid tissue without malignancy. This case suggests that a thorough clinical evaluation with proper radiological imaging modalities is essential for the correct diagnosis. One should have in mind that ectopic thyroid tissue could be present outside the migration way of the thyroglossal duct and present as a submandibular neck mass. [ABSTRACT FROM AUTHOR]

Ectopic thyroid tissue is a rare entity, resulting from developmental abnormality during the migration of the embryonic thyroid germ from the floor of the primitive foregut to its final pre-tracheal position. Although ectopic thyroid tissue may be located anywhere, its location at the skull base is extremely rare. We report a case of ectopic thyroid tissue at the skull base in a 19-year-old man with multimodality imaging findings. [ABSTRACT FROM AUTHOR]

Ectopic thyroid tissue in the lateral neck is a rare finding, especially in the submandibular region. This case report presents a 38-year-old female patient with swelling in the lateral cervical neck. Due to a thyroid goitre, right hemithyroidectomy was performed in the past. However, a persistent high thyroglobulin level was detected after surgery. Regarding the suspected tumour in the submental region, a cervical magnetic resonance imaging (MRI) was performed, which revealed a suspicious looking mass. The patient underwent complete surgical excision and the histopathological report concluded that the tumour was ectopic thyroid tissue. Her thyroglobulin level decreased back to a normal level after excision of the submandibular mass. These results show that ectopic thyroid tissue must be considered a differential diagnosis for patients with unclear swelling in the submental region. [ABSTRACT FROM AUTHOR]

Ectopic intrapulmonary thyroid tissue is extremely rare and considerably difficult to diagnose without surgery. Ectopic thyroid tissue, described as a mediastinal tumor, and intrapulmonary lesions are infrequent. An abnormal shadow was detected upon chest X-ray in a 60-year old woman with a history of benign thyroid goiter. A computed tomography scan revealed a solitary nodule measuring 27 mm in diameter in the left lower lobe, the diameter of which had increased by 5 mm since initial observation eight years ago. A thoracoscopic wedge resection was performed and the lesion was determined to be a non-invasive, soft-tissue tumor. It was pathologically diagnosed as an ectopic thyroid follicular adenoma. The course of the tumor was uneventful. A diagnosis of ectopic intrapulmonary thyroid should be made cautiously and only after ruling out metastasis of a follicular adenoma or thyroid carcinoma. This diagnosis of ectopic thyroid tissue was made possible by the surgical approach. [ABSTRACT FROM AUTHOR]

Intracardiac ectopic thyroid tissue is an extremely rare condition, with only 37 cases reported in the English literature. We present a case of intracardiac ectopic thyroid adenoma and briefly review the published reports. [ABSTRACT FROM AUTHOR]

We describe a case of ectopic cervical thyroid tissue which was involved by fibrosing Hashimoto's thyroiditis and which mimicked metastatic papillary thyroid carcinoma both on fine needle aspiration cytology and biopsy. The patient underwent total thyroidectomy which revealed fibrosing Hashimoto's thyroiditis, but no carcinoma. The entire thyroidectomy specimen was submitted for histopathological assessment. Even in the resected thyroidectomy specimen, there were cytological changes that were strongly reminiscent of papillary thyroid carcinoma. However, interpreted in the correct clinico-pathological context, these cytological alterations were deemed to be reactive secondary to the fibro-inflammatory process. [ABSTRACT FROM AUTHOR]

Thyroid tissue in an ectopic location (choristoma) seen in the gall bladder is a rare entity. We report a case of thyroid tissue in an ectopic location in gall bladder in a 29 year old woman with recurrent abdominal pain. Abdominal ultrasonography showed multiple gall stones and after cholecystectomy, the histopathology showed thyroid tissue in an ectopic location seen in the wall of the gall bladder. [ABSTRACT FROM AUTHOR]

Intra-pericardial heterotopic thyroid (IPHT) is an incidental finding during open-heart surgery. Although heterotopic thyroid has been reported in different parts of the body, only a few cases of intra-pericardium have been reported so far. In most articles, intracardiac, intrathoracic and heterotopic thymus cases are mistakenly included as IPTH cases A 57-year-old man with a history of non-Hodgkin lymphoma, who was treated 8 years ago and recovered, is now a candidate for surgery due to clear cell renal carcinoma in the left kidney with inferior vena cava (IVC) thrombus tumor that has spread into the right atrium. At the same time, he was operated on by two teams of urology and heart surgery. The patient's kidney was removed, and then he was subjected to sternotomy by the heart surgery team to remove the thrombus tumor. After opening the pericardium inside the pericardial cavity, a pericardial mass measuring 1x2 x3 cm, which was connected to the lower surface of the aortic arch by a 1 cm long stalk, was observed. It was resected and sent to pathology laboratory. The rest of the surgery to remove the thrombus tumor from inside the right atrium and IVC continued according to the procedure. The pathological report was benign thyroid tissue. Actual cases of IPTH are underreported, and due to the small number, it is not yet possible to comment on the prevalence of malignancy in it or its functional role; However any lesion or abnormal mass in the pericardial cavity should be respected and sent to pathology laboratory therefore by collecting information about these masses, in the future, decisions can be made and summarized. [ABSTRACT FROM AUTHOR]

Ectopic thyroid (ET) is a developmental anomaly of the thyroid gland with the presence of thyroid tissue at sites other than the normal cervical location anterior to second and third tracheal ring due to abnormal migration of the gland. It may be found along the path of descent of the developing thyroid primordium from the foramen caecum to the isthmus of the thyroid and up to the base of the diaphragm. Dual thyroid ectopia, where ET tissue is simultaneously present at two different abnormal locations, is a very rare developmental defect. Only a few cases have been reported worldwide. ET is predominantly seen in females and during puberty when the hormonal demand is high. Patients with ET may remain asymptomatic or present with swelling in the neck, symptoms such as dysphagia, dysphonia, dyspnea, and features of hypothyroidism. The diagnosis is usually made on clinical examination, laboratory tests, imaging studies, and cytology. Careful clinical evaluation is essential as ET may be the only functioning thyroid tissue. Thyroid scintigraphy is an important imaging tool and the gold standard for the diagnosis of ET tissue, as it has high sensitivity and specificity. Early and accurate diagnosis of ET is essential to start hormone replacement and avoid unnecessary surgery. The authors report here a series of four patients with dual ET tissue, diagnosed on thyroid scintigraphy. [ABSTRACT FROM AUTHOR]

Iodine-123/iodine-131 (123I/131I)-metaiodobenzylguanidine (mIBG) scan is an established tool for the localization and treatment of neuroendocrine tumors such as paragangliomas (PGL). To minimize thyroid irradiation by the radioactive iodine in the mIBG preparation, blockade of thyroidal iodine uptake with high doses of stable iodine used to be given routinely as part of all mIBG protocols. As 123I is now more frequently utilized than 131I, concern about thyroid radiation has lessened and thyroid blockade is often considered unnecessary. However, in certain situations, the lack of thyroid blockade can significantly impact treatment decisions. This report describes 2 patients who had mediastinal masses incidentally discovered on CT scans, and on further evaluation were found to have symptoms suggesting catecholamine excess with mildly elevated plasma normetanephrine levels. 123I-mIBG scans were performed without thyroid blockade, which demonstrated accumulation of tracer in the masses that were therefore deemed positive for PGL. Both patients underwent surgical resection of the masses with their surgical pathology revealing ectopic thyroid tissue (ETT). These cases illustrate that if appropriate thyroid blockade is not performed, ETT concentrating radioiodine from mIBG can lead to falsely positive mIBG scans and unnecessary surgical procedures. We conclude that in the setting of a mass suspicious for PGL in a location potentially representing ETT, such as the mediastinum, thyroid blockade should be employed for mIBG protocols to avoid false positive scans caused by ETT. [ABSTRACT FROM AUTHOR]

Background: Ectopic thyroid tissue in the iris, also known as a thyroid glandular epithelial choristoma of the iris, has only been described twice in the literature. In both cases it remained asymptomatic.Case Presentation: A 67-year-old female patient presented for the first time in mid-2017 with corneal endothelial decompensation, with a history of complicated cataract surgery and IStent® implantation. Slit lamp microscopy showed endothelial decompensation, pseudophakia, anterior synechiae and a whitish iris tumour adhering to the endothelium. The latter had existed since childhood. Given these findings, reduced visual acuity of hand movement perception and an intraocular pressure of 23 mmHg, we performed a keratoplasty combined with an en bloc resection of the iris tumour at 9 o'clock and sector iridectomy at the end of 2019. Histological and immunohistological examination of the iris tumour unexpectedly revealed thyroid tissue. After the procedure described above, the patient had an increase in visual acuity while the graft stayed clear and the eye showed no evidence of tumour recurrence or other complications.Conclusions: We report a third case of ectopic thyroid tissue in the iris. Both previous cases remained asymptomatic, whereas in our case, size and location of the ectopic thyroid tissue contributed to a more complex cataract surgery resulting in endothelial decompensation. Therefore, in such cases appropriate patient information should be provided prior to cataract surgery. Furthermore, careful histological examination and examination of the thyroid is important to exclude malignant diagnoses such as a metastasis of a follicular thyroid carcinoma. [ABSTRACT FROM AUTHOR]

Lingual thyroid as the name suggests it is an ectopic positioning of thyroid gland which is a rare developmental anomaly. Thyroid gland is usually located in the same level as that of cricoids cartilage in human body. Ectopic occurrence of thyroid gland can be seen anywhere from tongue to diaphragm though in ninety percent of reported cases it is generally seen in base of tongue. Lingual thyroid mainly seen as a result of the inability of thyroid gland to descend to its normal anatomical position during embryogenesis. Generally it takes its origin from the epithelial tissues of non-obliterated thyroglossal duct. From infancy to adulthood mostly faced problems by the patients are dysphagia, dysphonia, upper respiratory tract obstruction. So this review is entirely about the pathophysiology, clinical manifestation and diagnostic criteria along with treatment modalities for a better understanding of the dental professionals. [ABSTRACT FROM AUTHOR]

The current study reports the case of multifocal ectopic thyroid tissues in the breast. Ectopic thyroid tissue is an uncommon entity found not only in the cysts of thyroglossal ducts, but also along the thyroglossal duct. The most frequent location of this tissue is the base of the tongue, but they can also occur in the anterior tongue, submandibular or sublingual region, larynx, trachea, mediastinum and heart. Only a single case of ectopic thyroid tissue in breast has been previously reported in English literature. However, the current case was associated with abnormal embryological development compared with previous reports, which are attributed to abnormal implantation. [ABSTRACT FROM AUTHOR]

Lateral ectopic thyroid is a rare event and even more uncommon is a primary malignancy in lateral ectopic thyroid. We present a case of papillary adenocarcinoma in lateral ectopic thyroid in submandibular space in a 55-year old male. To our knowledge this is the third case documented in the world and the first one in Europe. Lateral ectopic thyroid in this region is easily masqueraded as a submandibular gland swelling and so was our patients’ tumor preliminarily diagnosed as a submandibular gland tumor. Furthermore, in the preoperative computed tomography (CT) scan the tissue was misinterpreted being adjacent to the submandibular gland. The diagnosis was revealed during the surgery and confirmed by the histology. This report demonstrates the difficulty in the differential diagnosis of neck masses. Although rare, ectopic tissue should be remembered as a possible diagnosis of all neck masses and the relevant preoperative examination should be performed by skilled professionals. [ABSTRACT FROM AUTHOR]

Foci of ectopic thyroid tissue are uncommon. Most sites of thyroid ectopia are confined to the neck region. The presence of ectopic thyroid tissue outside the migration pathway of the primitive thyroid in other locations is exceptional. Given that any disease of the thyroid gland may also affect ectopic thyroid tissue, pathologists has to recognize benign or malignant conditions that may develop in the ectopic focus. We present the case of a 32-year-old woman with ectopic thyroid parenchyma in the adrenal gland. Clinically, postoperative thyroid ultrasound echography and computed tomography scans did not reveal any thyroid tumor. The ectopic tissue was a cyst bordered by mature follicular thyroid structures and was histologically benign, without the molecular alterations associated with malignant tumors of follicular cell derivation (BRAFV600E, N-RAS, H-RAS, K-RAS). Review of the literature reveals that adrenal ectopic thyroid tissue is nearly always cystic and has distinctive pathologic features. [ABSTRACT FROM AUTHOR]

Ectopic thyroid gland is a rare condition usually presenting with neck swelling or hypothyroidism. In most cases, ectopic thyroid tissue is the only functioning thyroid tissue, but it may rarely be associated with normal thyroid gland. Thyroiditis in an ectopic thyroid gland is very rare. Here, we describe a 13-year-old girl who was initially suspected, as a having a thyroglossal cyst. Thyroid functions were suggestive of thyrotoxicosis. She was diagnosed to have simultaneous occurrence of thyroiditis in the ectopic and eutopic thyroid glands. This case was exceedingly rare since this patient presented with thyrotoxicosis unlike previous reported cases who were either euthyroid or hypothyroid. [ABSTRACT FROM AUTHOR]

Background: Through a review of three cases, the etiopathogenetic, clinical-diagnostic, and therapeutic aspects of ectopic thyroid tissue are herein discussed to highlight the main presentations of this polymorphous disease. Case presentations: The first case involved an ectopic thyroid gland in the lingual area in a 45-year-old Caucasian woman who presented with dysphagia and midline swelling at the base of the tongue. The second case involved a 22-year-old Caucasian woman with a submandibular mass comprising ectopic thyroid tissue. The third case involved a 33-year-old Caucasian man with a typical thyroglossal duct cyst characterized by the presence of thyroid tissue upon histological analysis. Conclusion: Surgery seems to be the most appropriate treatment for patients with ectopic thyroid tissue showing clinical signs of upper airway obstruction or when the lesion shows signs of infection or malignant degeneration. When a site of ectopic thyroid tissue is the only such site in the body, removal of this tissue will usually lead to hypothyroidism that requires medical thyroid hormone replacement. [ABSTRACT FROM AUTHOR]

Described is a rare presentation of ectopic thyroid tissue as a lateral neck mass. This case raises the awareness that a lateral neck mass (including ectopic thyroid mass) needs appropriate investigations to rule out malignancy. [ABSTRACT FROM AUTHOR]

The patient's thyroid gland appeared normal, and there was no evidence to suggest metastasis from a primary tumor in the thyroid or a germ cell tumor. It is also particularly important to recognize that ETT may be the only functional thyroid tissue,5 to treat the patient before surgery if hypothyroid, to maintain the patient in a euthyroid state if the patient is. Keywords: Ectopic thyroid tissue; vocal cord; thyroid function; treatment EN Ectopic thyroid tissue vocal cord thyroid function treatment E1391 E1392 2 03/12/21 20210401 NES 210401 INTRODUCTION The thyroid gland is located anterior-laterally to the second and fourth tracheal cartilage. [Extracted from the article]

Ectopic thyroid tissue in ovarian teratoma or in struma ovarii appears to be histologically identical to the thyroid gland tissue and may virtually exhibit all the pathological patterns found in the thyroid gland. However, the concurrent lymphocytic infiltration of the thyroid gland, as found in Hashimoto's thyroiditis, and of the ectopic thyroid tissue is extremely rare. We describe the case of an 18-years old patient, in which a right ovarian 4 cm cyst has been found during pelvic ultrasound exam. The cyst was resected and microscopic examination of the mass revealed a mature cystic teratoma in which epidermal-like lining with skin adnexa, admixed with respiratory type epithelium, and areas of mature fatty, chondroid and dentigerous tissues were found. In a peripheral area of 0.7 cm × 0.5 cm, a prominent lymphocytic infiltrate surrounding thyroid follicles was identifiable. Thyroid function evaluation at different time points after surgery, revealed the development of mild hypothyroidism. Anti-TPO and anti-Tg autoantibodies were elevated, at fine needle aspiration biopsy a lymphocytic infiltrate, compatible with Hashimoto's thyroiditis, was present. We report here a rare case of Hashimoto's thyroiditis occurring both in the thyroid and in the ectopic thyroid tissue in the context of a benign cystic teratoma of the ovary. [ABSTRACT FROM AUTHOR]

Ectopic thyroid tissue refers to the presence of thyroid tissue in locations other than normal anterior neck region. It is the most frequent type of thyroid dysgenesis. Lingual thyroid is the most common type accounting for 90% of the cases. The presence of thyroid tissue in orbit is extremely rare along with malignant transformation and the presence of normal thyroid gland. We report a very rare case of follicular carcinoma arising in the ectopic thyroid tissue in the left orbit along with normal thyroid gland. To the best of our knowledge, it is the first ever reported case of this type. [ABSTRACT FROM AUTHOR]

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Abnormal Pertechnetate distribution can occur due to many reasons such as retrosternal extension of eutopic thyroid gland, ectopic functioning thyroid gland, physiological uptake in esophagus, teratoma having functioning thyroid tissue component, metastatic lymph nodes and sequestered thyroid nodule. We present a case of thyrotoxicosis with hyper functioning thyroid gland and two abnormal foci of uptake in the mediastinum in a linear fashion that mimcked esophageal activity. These foci persisted even after consuming water. SPECT localised these foci in retrosternal and likely to be ectopic functioning thyroid. Retrosternal ectopic thyroid tissue may not usually be detected on Tc-99m scan due to attenuation of low-energy gamma rays by sternal bone. However, hyperfunctioning tissue enabled visualization of the retrosternal ectopic thyroid. [ABSTRACT FROM AUTHOR]

Ectopic thyroid tissue is usually found in the midline along the path of descent of the thyroid gland, such as in the tongue, larynx, trachea, oesophagus, etc. Initially, laterally placed thyroid tissues were found to contain malignant tissue and hence the term lateral aberrant thyroid tumours. Some attributed these to metastatic deposits of primary thyroid carcinoma while others felt that these were primary tumours of aberrant thyroid tissue. In later years, benign ectopic thyroid tissues were described in the lateral neck. It was felt that ectopic thyroid tissues are derived from thyroid cell rests that have failed to fuse with the main thyroid tissue during development. They are subjected to the same goitrogenic stimulation as the normally placed thyroid tissue. Our case supports the view that not all laterally placed thyroid tissues are malignant and also presents an unusual subplatysmal location of ectopic thyroid tissue. [ABSTRACT FROM AUTHOR]

A case of papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst is described. A 46-year-old woman presented with a 2.0 × 2.0 cm mass in her left lateral neck. The excised mass showed a cystic lesion with a thyroid papillary carcinoma. Following a lateral cervical cystectomy, subsequent thyroid gland and lymph nodes dissections were performed. Pathological examination showed an adenomatous goiter and no primary carcinoma in the thyroid gland, as well as metastatic papillary carcinoma in the lymph nodes. Two cases of thyroid papillary carcinoma arising in ectopic thyroid tissue within a branchial cyst have been reported previously, but no lymph node metastases were recognized. The first case of papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst, and accompanied by lymph node metastasis is presented. [ABSTRACT FROM AUTHOR]

We described a case of benign struma ovarii associated to bilateral mature cystic ovarian teratoma in an asymptomatic post-menopausal woman with breast cancer. The patient synchronously underwent surgical treatment of breast and ovarian tumors. [ABSTRACT FROM AUTHOR]

BACKGROUND: Ectopic Thyroid Tissue is the most common form of thyroid dysgenesis. But primary malignant transformation in ectopic thyroid tissue is quite a rare entity, with follicular malignancy being the dominant form at ectopic sites. Very infrequently, malignant ectopic thyroid tissue can present with metastasis to lymph nodes. But we report a case of malignant ectopic thyroid tissue over manubrium sterni with distant metastasis. CASE REPORT: A 42-year-old Pakistani female presented to us in Endocrine clinic with gradually increasing swelling on anterior aspect of manubrium sterni for last 6 months. She had no goitre & was clinically and biochemically euthyroid. Rest of systemic exam was also unremarkable. CT chest showed a circumscribed soft tissue density mass arising from sternum, measuring 3.9 x 3.9cm, causing erosions of anterior, right lateral & posterior walls of sternum. Trucut biopsy of the sternal mass proved it to be thyroid tissue with follicular differentiation and occasional mitotic figures. Multiple nodules were also noted in Thyroid gland in US Neck. She underwent total Thyroidectomy & excision of ectopic thyroid tissue over manubrium sterni. Extensive histopathological examination of primary thyroid gland showed benign nodular hyperplasia with no evidence of malignancy. Ectopic thyroid tissue showed minimally invasive follicular thyroid carcinoma with tumor size of 3.2 x 2.3cm. Her postoperative 21-day biochemical profile showed TSH 22.345 µIU/ml (0.4 to 4.2), Serum Thyroglobulin 88.3ng/ml, Anti-TG antibodies <20.0IU/ml. Based on the histopatholigical diagnosis, she went through 30mCi RAI131 ablation. The post-ablative whole body scan showed good uptake of ablative dose over thyroid bed and evidence of multiple well-defined rounded areas of abnormally increased tracer accumulation over mid and lower dorsal spine, lumbar region and right iliac bone, representing bone metastasis. It was followed by MRI spine which showed foci of metastatic deposits in T1-T3 and L2 vertebral bodies & abnormal signals showing post-contrast enhancement in superior mediastinum with invasion of medial ends of both clavicles, more marked on right side. So patient was found to have malignant ectopic thyroid tissue with distant bone metastasis. CONCLUSION: To the best of our knowledge, we describe the first case of its kind having malignant ectopic thyroid with metastasis to spine & ilium. Such cases appear difficult to manage and may impose difficulties in making their treatment decisions. [ABSTRACT FROM AUTHOR]