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The article discusses abnormalities in Thyroid function tests (TFTs) that help in diagnosis of primary thyroid disorders as well as secondary or central thyroid disorders. The review discusses hypothyroidism and states that on finding an "abnormal" TFT, the physician recommends parents the referral to a pediatric endocrinologist. This review provides pediatricians with guidelines that will help them distinguish between variants of normal from true thyroid pathology.

Ectopic thyroid is an uncommon condition defined as the presence of thyroid tissue at a site other than the pretracheal area. When the process of embryologic migration is disturbed, aberrant thyroid tissue may appear. In most cases, ectopic thyroid is located along the embryologic descent path of migration as either a lingual thyroid or a thyroglossal duct cyst. In rare cases, aberrant migration can result in lateral ectopic thyroid tissue. Approximately 1 to 3% of all ectopic thyroids are located in the lateral neck. Ectopic tissue frequently represents the only presence of thyroid tissue; a second site of orthotopic or ectopic thyroid tissue is found in other cases. The presentation of ectopic thyroid as a lateral mass should be differentiated from metastatic thyroid cancer; other differential diagnoses include a submandibular tumor, branchial cleft cyst, carotid body tumor, and lymphadenopathy of various etiologies. In addition to the history and physical examination, the workup for a patient with a submandibular mass suspicious for ectopic thyroid should include (1) technetium-99m or iodine-131 scintigraphy, (2) ultrasonography and either computed tomography or magnetic resonance imaging, (3) fine-needle aspiration biopsy, and (4) thyroid function testing. No treatment is required for asymptomatic patients with normal thyroid function and cytology, but hypothyroid patients should be placed on thyroid hormone replacement therapy. Most cases are diagnosed postoperatively. Surgical treatment of ectopic thyroid should be considered when a malignancy is suspected or diagnosed, when the patient is symptomatic, or when thyroid suppression therapy fails. [ABSTRACT FROM AUTHOR]

A lingual thyroid is a mass of ectopic thyroid tissue located in the midline of the base of the tongue. Its estimated prevalence ranges from 1 in 3,000 to 1 in 10,000 population. We report the interesting case of a 28-year-old woman who presented with a primary papillary carcinoma in a lingual thyroid and a histologically normal thyroid gland. To the best of our knowledge, this case probably represents only the second reported case of a follicular variant of a papillary carcinoma arising in a lingual thyroid. [ABSTRACT FROM AUTHOR]

The article focuses on thyroid hemiagenesis, a rare congenital anomaly detected during imaging for other conditions. An overview is provided concerning the thyroid rudiment. Two cases are described involving a 48-year-old man who presented for a workup of an apparent palpable mass on the right side of the neck and a 25-year-old woman with pharyngitis and difficulty in opening her mouth and swallowing. Most common pathologies are identified to be hyperthyroidism, hypothyroidism and goiter.

The article argues that tumors that occur in the thyroid gland as a result of lymph or vascular spread from distant sites are considered to represent metastatic disease rather than a direct extension of a primary from an adjacent organ. Although a thyroid gland mass may be the presenting clinical sign, it is more often the underlying thyroid gland disease that prompts clinical evaluation. Immunohistochemistry analysis will help with the separation between primary and metastatic tumors.