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The thyroid is the first endocrine gland to form during embryogenesis. At this stage, incomplete or anomalous migration of thyroid tissue causes ectopic localization of the gland. Submandibular ectopic thyroid tissue with a coexisting normally located thyroid gland is extremely rare. In this case aimed to present the findings of the 65-years-old female patient who is bilateral subtotal thyroidectomy operation performed for multinodular goiter of 12 years ago. Case, painless mass in the right submandibular and infrahyoid region for 6 months was admitted to our clinic with complaints. Result of contrast-enhanced neck computed tomography, ultrasound-guided fine-needle aspiration biopsy and thyroid scintigraphy were found of functional residual thyroid tissue in the normal localization as well as 2×3 cm mass in the submandibular area and 1×2 cm mass lesion in the infrahyoid region. The patient referred to excisional biopsy. Normal thyroid foilicules and no evidence of malignancy were found in specimen pathologically. Postoperative foliow-up of thyroid function tests were normal. [ABSTRACT FROM AUTHOR]

A wide range of morphological and developmental variations of thyroid gland like hypoplasia, ectopic thyroid tissue, hemiagenesis or agenesis of thyroid gland has been reported. Out of these agenesis of the thyroid isthmus is a very rare congenital anomaly. Thyroid isthmus agenesis does not manifest clinical symptoms, and it can be confused with other thyroid pathologies. Also the presence of levator glandulae thyroideae and its anatomical variations gain importance in the pathologies which are related to thyroid gland and their treatment modalities. We hereby, report the absence of isthmus and presence of levator glandulae thyroideae and pyramidal lobe in a middle aged male cadaver. The present case report is an attempt to highlight the implications of variation of thyroid gland from diagnostic, phylogenetic and functional perspectives. [ABSTRACT FROM AUTHOR]

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]

Background: Incidental thyroid abnormalities detected on US examinations in children have not been well documented. Objective: To determine prevalence of incidental thyroid abnormalities depicted by US in children and to describe the spectrum of appearances. Materials and methods: Retrospective analysis of clinical and US findings in children who had neck US from January 2006 to December 2007. Results: Of 1,228 neck US exams, thyroid was depicted in 287 children (mean age = 6.2 years). Incidental thyroid abnormalities were detected in 52 (18%) (mean age = 8.1 years). In 35 there were small (<4 mm), well-defined cysts, some with a hyperechoic punctate focus. In nine there were hypoechoic, solid nodules with smooth, straighter margins with echogenicity similar to thymus, suggesting intrathyroid ectopic thymus (mean age = 2.5 years). In three others there were tiny hyperechoic foci without nodules. Other abnormalities included hypoechoic target-like lesions ( n = 2), isoechoic nodule ( n = 1), multiple hypoechoic foci ( n = 1) and non-visualized thyroid lobe resulting from adjacent abscess ( n = 1). None of the children developed thyroid dysfunction or malignancy. Conclusion: There is a spectrum of incidental thyroid abnormalities in children. These US findings should be interpreted cautiously, avoiding unnecessary referrals and investigations. Intrathyroid ectopic thymus is more common than previously thought, occurs much more frequently in younger boys and should be considered if the lesion has US characteristics of thymus. [ABSTRACT FROM AUTHOR]

Thyroid imaging is of proven help in establishing a diagnosis of congenital hypothyroidism in infants. US often shows tissue in the thyroid fossa when radionuclide scintigraphy reveals only ectopic uptake. Our hypothesis was that the use of US alone could lead to the mistaken diagnosis of normal or dysplastic thyroid in cases of scintigraphy-proven thyroid ectopia. We undertook a detailed retrospective review and analysis of imaging and concurrent biochemistry in infants with thyroid ectopia, confirmed by radionuclide scintigraphy. Eighteen infants had thyroid ectopia; ten of the original US reports had suggested that cervical thyroid tissue was present. Review showed bilateral tissue in the thyroid fossa in all that was non-thyroidal in nature since, apart from showing no radionuclide uptake, it exhibited some or all of the following typical features: hyperechogenicity, heterogeneity, small size, poor vascularity, and anechoic and/or hypoechoic cysts. Also, extension of the tissue both around and behind the large cervical blood vessels was a universal finding. Considerable experience is required to interpret neonatal thyroid US. We caution against diagnosing a dysplastic/hypoplastic thyroid gland in situ on the basis of US alone, particularly if the tissue exhibits any of the non-thyroidal features described. [ABSTRACT FROM AUTHOR]

Developmental morphological abnormalities of the thyroid gland are very rare. Thyroid lobe hemiagenesis is a very rare abnormality, in which one thyroid lobe fails to develop. Ectopic thyroid is one of the common developmental anomalies of thyroid characterized by the presence of thyroid tissue in a site other than its usual. Of all, lingual thyroid is the most common manifestation of benign ectopic thyroid tissue, but it is still a rare clinical entity. Both of them seen together is even rarer. These developmental defects may or may not be associated with thyroid dysfunction. Ultrasonography (USG) is the initial modality of choice for thyroid hemiagenesis but further evaluation by computed tomography (CT) scan or nuclear scan should be done to look for other thyroid ectopic tissue rest. We report a case of right thyroid hemiagenesis with ectopic lingual thyroid in a 13-year-old female. To the best of our knowledge, only two similar cases in the world literature have been reported till date. [ABSTRACT FROM AUTHOR]

The article describes the case of a 73-year-old woman who developed intralaryngeal ectopic thyroid tissue (ETT). The patient presented with a painless mass on the right side of her neck. The ETT was found while she was undergoing evaluation for thyroid enlargement. Some theories regarding the etiology of intralaryngeal ETT are discussed.

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]

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]

Intratracheal ectopic thyroid tissue is a rare finding that can cause airway obstruction. The symptoms can easily be confused with those of bronchial asthma. We describe the case of a 30-year-old woman with subglottic thyroid tissue who had been misdiagnosed earlier with bronchial asthma. After the correct diagnosis was established, the intratracheal nodule was removed by segmental tracheal resection extended to the anterior arch of cricoid ring, and thyrotracheal anastomosis was performed by cervicotomy. Currently, the patient is free of disease and complaint. We also discuss the clinical features and management of intratracheal thyroid tissue. [ABSTRACT FROM AUTHOR]