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Chopra A, Singh Y, Kaushal M, Taneja A, Kulshreshtha B. Simultaneous Occurrence of Thyroiditis in Ectopic and Eutopic Thyroid Masquerading as Thyroglossal Cyst. J Clin Diagn Res 2017; 11:OD17-OD19. [PMID: 28658835 DOI: 10.7860/jcdr/2017/25192.9897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 03/16/2017] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Aditi Chopra
- Senior Resident, Department of Endocrinology, PGIMER, Dr RML Hospital, Delhi, India
| | - Yogendra Singh
- Senior Resident, Department of Endocrinology, PGIMER, Dr RML Hospital, Delhi, India
| | - Manju Kaushal
- Professor, Department of Pathology, Dr RML Hospital, New Delhi, India
| | - Anil Taneja
- Professor, Department of Radiology, Dr RML Hospital, Delhi, India
| | - Bindu Kulshreshtha
- Associate Professor, Department of Endocrinology, PGIMER, Dr RML Hospital, Delhi, India
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Cunha FM, Rodrigues E, Oliveira J, Saavedra A, Vinhas LS, Carvalho D. Graves' disease in a mediastinal mass presenting after total thyroidectomy for nontoxic multinodular goiter: a case report. J Med Case Rep 2016; 10:70. [PMID: 27029843 PMCID: PMC4815244 DOI: 10.1186/s13256-016-0878-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thyrotoxicosis after total thyroidectomy is mostly iatrogenic. Rarely, a hyperfunctional thyroid remnant or ectopic tissue may be the cause. There are few cases of Graves' disease arising from thyroid tissue located in the mediastinum and none in which Graves' disease was diagnosed only after surgery. We report the case of a patient with Graves's disease in a mediastinal thyroid mass presenting 7 years after total thyroidectomy for nontoxic goiter. CASE PRESENTATION A 67-year-old Caucasian woman presented with palpitations, fatigue and weight loss. She had a history of total thyroidectomy for nontoxic multinodular goiter at the age of 60 without any signs of malignancy on microscopic examination. She had been medicated with levothyroxine 100 μg/day since the surgery without follow-up. She was tachycardic, had no cervical mass or eye involvement. Her thyroid-stimulating hormone levels were suppressed (0.000 μU/mL) and her free thyroxine (3.22 ng/dL) and free triiodothyronine (8.46 pg/mL) levels increased. Neither mediastinal enlargement nor trachea deviation was found on chest roentgenogram. Levothyroxine treatment was stopped but our patient showed no improvement on free thyroxine or free triiodothyronine 10 days later. Thyroglobulin was increased to 294 mg/mL. A cervical ultrasound scan revealed no thyroid remnant. Her anti-thyroid-stimulating hormone receptor antibodies were high (19.7 U/L). Corporal scintigraphy demonstrated increased intrathoracic radioiodine uptake. A computed tomography scan confirmed a 60 × 40 mm mediastinal mass. Methimazole 10 mg/day was started. Three months later, her thyroid function was normal and she underwent surgical resection. Microscopic examination showed thyroid tissue with no signs of malignancy. CONCLUSIONS Although thyrotoxicosis after total thyroidectomy is mostly due to excessive supplementation, true hyperthyroidism may rarely be the cause, which should be kept in mind. The presence of thyroid tissue after total thyroidectomy in our patient may correspond to a remnant or ectopic thyroid tissue that became hyperfunctional in the presence of anti- thyroid-stimulating hormone receptor antibodies.
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Affiliation(s)
- Filipe Manuel Cunha
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, 4202-451, Porto, Portugal. .,Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
| | - Elisabete Rodrigues
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, 4202-451, Porto, Portugal.,Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Joana Oliveira
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, 4202-451, Porto, Portugal.,Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Ana Saavedra
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, 4202-451, Porto, Portugal.,Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Luís Sá Vinhas
- Serviço de Cirurgia Geral, Centro Hospitalar de São João, Porto, Portugal
| | - Davide Carvalho
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, 4202-451, Porto, Portugal.,Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Szczepanek-Parulska E, Ruchala M, Hernik A. Unexpected conversion from hypothyroidism to an euthyroid state due to Graves' disease in a patient with an ectopic thyroid. Endocrine 2014; 46:684-5. [PMID: 24282039 PMCID: PMC4102823 DOI: 10.1007/s12020-013-0117-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 11/05/2013] [Indexed: 11/02/2022]
Abstract
A 15-year-old woman was diagnosed with hypothyroidism and unilateral ectopic thyroid. Levothyroxine treatment was introduced; however, the patient was non-compliant and took the medication irregularly. When she presented to an endocrinologist at the age of 30, she had not been using levothyroxine for at least 6 months. Surprisingly, she was clinically and biochemically euthyroid. Due to decreased echogenicity on ultrasound examination, enhanced vascularization on Color Doppler examination and increased concentration of anti-TSH receptor autoantibodies, she was diagnosed with Graves' disease. Eventually, she underwent total thyroidectomy due to diagnosis of follicular neoplasm in fine-needle aspiration biopsy of the focal lesion found in the thyroid gland. To our knowledge, our patient is the first described with ectopic thyroid, presenting a nodular variant of Graves' disease and no signs of orbitopathy, who was initially hypothyroid and became euthyroid in the course of autoimmune thyroid disease.
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Affiliation(s)
- Ewelina Szczepanek-Parulska
- Department of Endocrinology, Metabolism and Internal Medicine, University of Medical Sciences, 49 Przybyszewskiego St., 60-355 Poznan, Poland
| | - Marek Ruchala
- Department of Endocrinology, Metabolism and Internal Medicine, University of Medical Sciences, 49 Przybyszewskiego St., 60-355 Poznan, Poland
| | - Aleksandra Hernik
- Department of Endocrinology, Metabolism and Internal Medicine, University of Medical Sciences, 49 Przybyszewskiego St., 60-355 Poznan, Poland
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Scintigraphic detection of dual ectopic thyroid tissue: experience of a Chinese tertiary hospital. PLoS One 2014; 9:e95686. [PMID: 24748408 PMCID: PMC3991721 DOI: 10.1371/journal.pone.0095686] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 03/31/2014] [Indexed: 12/14/2022] Open
Abstract
Purpose To assess scintigraphic pattern, clinical indication and relevance of dual ectopic thyroid tissue (ETT). Literature is reviewed for such cases. Methods In this 5-year retrospective study, we reviewed all thyroid scintigraphies in our data base. Patients diagnosed with suspected ETT were identified. Literature is reviewed. Statistics were done by one-way analysis of variance and least significant difference test. Results From 11905 thyroid scintigraphies during the 5-year period, we retrieved 121 patients eligible for analysis. The top two indications were assessing a palpable front neck mass to determine whether it was an ETT, and primary hypothyroidism. Patients were divided into 3 groups. Group 1 with single ETT (83 cases); group 2 with dual ETT (6 cases) and group 3 with athyroid (32 cases). Age and thyroid hormones were highest in group 2, and lowest in group 3. Thyrotropin was highest in group 3, and lowest in group 2. Thyroxine was given to hypothyroid patients, while no surgery was performed. There were 42 published cases with dual ETT, most of whom were under 30 years old. 38.10% of them were euthyroid, 33.33% hypothyroid, and 21.43% subclinical hypothyroid. Most frequent ectopic positions included lingual (33.73%), sublingual (27.71%) and subhyoid (22.89%). Conclusions In our cohort, incidence of dual ETT was 0.05% if the denominator was total number of thyroid scintigraphies. The incidence was 4.96% if the denominator was the number of patients with suspected ETT. Important clinical indication is a front neck palpable mass suggestive of an ETT. Important clinical relevance of recognizing the dual ETT pattern is to avoid inappropriate surgery. After reviewing all published cases, we find dual ETT is often seen in young patients. Most of such patients are euthyroid or mildly hypothyroid. Thyroid ectopia often resides in lingual, sublingual and subhyoid areas.
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Khan SH, Rather TA, Syed T. Simultaneous occurrence of Graves' disease in eutopic and ectopic thyroid tissues: A case report and review of literature. Indian J Nucl Med 2013; 27:254-6. [PMID: 24019658 PMCID: PMC3759089 DOI: 10.4103/0972-3919.115399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Ectopic thyroid tissue an uncommon condition results from abnormal migration of the primitive thyroid bud. This may be the only functional thyroid. Ectopic thyroid tissue may sometimes coexist with the eutopic thyroid gland. Hyperthyroidism in association with ectopic thyroid tissue is very uncommon. We report a rare case of simultaneous involvement of ectopic and eutopic thyroid tissue in a married women of 35 years who was referred to our department for a technetium 99m thyroid scan. Coexisting ectopic and eutopic thyroid tissue due to identical histology may have similar response to various stimulatory and inhibitory factors like hormones and immunoglobulin's. Iodine-131 is an easy to administer and effective treatment for patients with simultaneous Graves' disease in the ectopic and eutopic thyroid tissues.
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Affiliation(s)
- Shoukat H Khan
- Department of Nuclear Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Tan TH, Lee BN, Hassan SZA, Ch'ng ES, Hussein Z. Dual thyroid ectopia with graves' disease: a case report and a review of the literature. Nucl Med Mol Imaging 2012; 46:300-3. [PMID: 24900078 DOI: 10.1007/s13139-012-0160-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 06/29/2012] [Accepted: 07/18/2012] [Indexed: 10/28/2022] Open
Abstract
Ectopic thyroid or thyroid ectopia is a rare developmental anomaly with the prevalence of 1 per 100,000-300,000 population. Even rarer, such an anomaly manifests as dual thyroid ectopia. To our best knowledge, only one case has been reported on dual thyroid ectopia with Graves' disease in the English literature. We present here a case of dual thyroid ectopia complicated by Graves' disease, whereby the diagnosis was rendered through judicious use of various diagnostic modalities coupled with a close clinical follow-up. In this case, therapeutic consideration should be personalized with proper informed consent of the patient.
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Affiliation(s)
- Teik Hin Tan
- Department of Nuclear Medicine, Kuala Lumpur Hospital, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Boon Nang Lee
- Department of Nuclear Medicine, Kuala Lumpur Hospital, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Siti Zarina Amir Hassan
- Department of Nuclear Medicine, Kuala Lumpur Hospital, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Ewe Seng Ch'ng
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Malaysia
| | - Zanariah Hussein
- Department of Endocrinology, Putrajaya Hospital, 62250 Putrajaya, Wilayah Persekutuan, Malaysia
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Jacob MJ, Ravina M. A rare case of lingual thyroid with hyperthyroidism: A case report and review of the literature. Indian J Endocrinol Metab 2012; 16:441-443. [PMID: 22629516 PMCID: PMC3354857 DOI: 10.4103/2230-8210.95708] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Lingual thyroid is a rare embryological anomaly resulting from failure of normal thyroid tissue to descend from the foramen cecum at base of tongue to its orthotopic location in front of the lower neck. It is a rare anomaly with a reported incidence of 1 in 3000 of the thyroid disorders. Lingual thyroid is often asymptomatic but may cause local symptoms such as dysphagia, dysphonia with stomatolalia, upper airway obstruction, and often with hypothyroidism. Hyperthyroidism is extremely rare finding and till now there are very few case reports published. We present here a case of lingual thyroid with hyperthyroidism, which was treated successfully with radioiodine.
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Affiliation(s)
| | - Mudalsha Ravina
- Department of Nuclear Medicine, Army Hospital Research and Referral, Dhaula kuan, New Delhi, India
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Noussios G, Anagnostis P, Goulis DG, Lappas D, Natsis K. Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity. Eur J Endocrinol 2011; 165:375-82. [PMID: 21715415 DOI: 10.1530/eje-11-0461] [Citation(s) in RCA: 197] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ectopic thyroid tissue is a rare entity resulting from developmental defects at early stages of thyroid gland embryogenesis, during its passage from the floor of the primitive foregut to its final pre-tracheal position. It is frequently found around the course of the thyroglossal duct or laterally in the neck, as well as in distant places such as the mediastinum and the subdiaphragmatic organs. Although most cases are asymptomatic, symptoms related to tumor size and its relationship with surrounding tissues may also appear. Any disease affecting the thyroid gland may also involve the ectopic thyroid, including malignancy. The clinician must distinguish between ectopic thyroid and metastatic deposits emerging from an orthotopic gland, as well as other benign or malignant masses. Thyroid scintigraphy plays the most important role in diagnosing ectopy, but ultrasonography contributes as well. In cases of symptomatic disease, surgery is the treatment of choice, followed by radioiodine ablation and levothyroxine suppression therapy in more refractory cases. This review provides current understanding about the wide clinical spectrum of this rare condition, also referring to optimal diagnostic approach, differential diagnosis, and management strategies.
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Affiliation(s)
- George Noussios
- Laboratory of Anatomy in Department of Physical Education and Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ectopic, submandibular thyroid causing hyperthyroidism. The Journal of Laryngology & Otology 2011; 125:1091-3. [PMID: 21774845 DOI: 10.1017/s0022215111000855] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Ectopic thyroid tissue in the submandibular region is exceptionally rare. Nevertheless, the treating physician should consider this condition within the differential diagnosis of a submandibular mass. METHOD Case report of ectopic thyroid tissue presenting as a submandibular mass in a patient with hyperthyroidism, together with a review of the English-literature concerning ectopic thyroid tissue. CONCLUSION To our knowledge, this is the first report of ectopic thyroid tissue presenting as a submandibular mass and causing hyperthyroidism. Removal of the submandibular mass resulted in normalisation of thyroid function, and subsequent reduction in the patient's antithyroid medication dosage. Ectopic thyroid tissue should be suspected in any patient with a submandibular mass. Prior to resection of such a lesion, it is essential to ensure that normal, functioning thyroid tissue is present elsewhere. Ectopic thyroid tissue can also present with pathology similar to that affecting the normal thyroid gland.
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Abellán Galiana P, Cámara Gómez R, Campos Alborg V, Rivas Sánchez A, Salom Fuster JV, Muñoz Gómez C. [Dual ectopic thyroid: subclinical hypothyroidism after extirpation of a submaxillary mass]. ACTA ACUST UNITED AC 2009; 28:26-9. [PMID: 19232175 DOI: 10.1016/s0212-6982(09)70213-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Ectopic thyroid tissue is a rare clinical entity, and more so when it is present in two different locations. We present the case of a 38-year-old euthyroid woman with submandibular and lingual ectopic thyroid tissue in the absence of a normally located thyroid gland, diagnosed after the extirpation of an asymptomatic mass misdiagnosed as a neoplasm of the submaxillary gland. Despite its low frequency, the possibility of ectopic thyroid should be considered when making a differential diagnosis of neck masses, using ultra-sound, thyroid scan and ultrasound-guided fine-needle aspiration biopsy.
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Affiliation(s)
- P Abellán Galiana
- Servicio de Endocrinología, Hospital Universitario La Fe, Valencia, España.
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Fujioka K, Fujioka A, Ban Y, Oishi M, Yano K, Sanuki E, Takahashi M, Tanaka Y, Ida M. A case of dual ectopic thyroid accompanied by positive antithyroid antibodies. J Med Ultrason (2001) 2008; 35:201. [PMID: 27278993 DOI: 10.1007/s10396-008-0198-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2007] [Accepted: 06/05/2008] [Indexed: 11/28/2022]
Abstract
Ectopic thyroid tissue is an uncommon congenital aberration that is seldom present at two different sites simultaneously. The patient was a 32-year-old woman with dual ectopic thyroid accompanied by positive antithyroid antibodies. The simultaneous occurrence of dual ectopic thyroid and positive antithyroid antibodies has been documented in only two cases: the case discussed here and one previous case. The cervical ectopic thyroid was followed up by ultrasound, which showed an increase in the size of the lesion and an internal echo texture that became slightly heterogeneous after the patient had her second child. We speculated that these changes resulted from the changes in hormone demand brought on by pregnancy and parturition.
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Affiliation(s)
- Kazumi Fujioka
- Department of Radiology, Nihon University School of Medicine, 30-1 Ohyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
| | | | - Yoshio Ban
- Department of Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Minoru Oishi
- Department of Neurology, Nihon University School of Medicine, Tokyo, Japan
| | - Kiyoshi Yano
- Department of Radiology, Nihon University School of Medicine, 30-1 Ohyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Eiichi Sanuki
- Department of Radiology, Nihon University School of Medicine, 30-1 Ohyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Motoichiro Takahashi
- Department of Radiology, Nihon University School of Medicine, 30-1 Ohyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Yoshiaki Tanaka
- Department of Radiology, Nihon University School of Medicine, 30-1 Ohyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Masahiro Ida
- Department of Radiology, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital, Tokyo, Japan
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Daumerie C, Duprez T, Boschi A. Long-term multidisciplinary follow-up of unilateral thyroid-associated orbitopathy. Eur J Intern Med 2008; 19:531-6. [PMID: 19013383 DOI: 10.1016/j.ejim.2008.01.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Revised: 10/27/2007] [Accepted: 01/20/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND Thyroid-Associated Orbitopathy (TAO) is an autoimmune disease characterized by orbital inflammation involving both adipose tissue and extra-ocular muscles (EOM). Whereas bilateral and possibly asymmetric orbital involvement is commonly found at radiological work-up, mono-orbital involvement is poorly documented, and ascribed to an initial and/or transient stage of subsequent bilateral TAO. METHODS From a cohort of two hundred TAO patients, we selected retrospectively fourteen patients with initial clinical unilateral TAO. Five of them were excluded because of clinical bilateralization. RESULTS The sex ratio was 0.8 (4M, 5F), and mean age 44.6 years (range: 18-63). All patients were euthyroid when the initial magnetic resonance imaging (MRI) was performed. One patient was treated with Levothyroxine, because of subclinical hypothyroidism. Eight patients (six smokers) suffered from Graves' disease, of 1-4 years duration, for which they were treated with antithyroid drugs. A thyroidectomy was performed in two patients. None of the patients ever received radioiodine. Six patients remained euthyroid after stopping of the antithyroid regimen, and two became hypothyroid. Seven patients had active, and two severe TAO. Four of nine patients exhibited bilateralization of TAO on initial MRI. Clinical status ultimately improved or normalized in all. In two patients, MRI performed after 9 years demonstrated partial shrinkage of previously enlarged EOMs, together with fatty involution of involved muscles. CONCLUSIONS Unilateral TAO is not different and just as severe as bilateral TAO. At initial work-up MRI shows signs of bi-laterality in 45% (4/9), with mild involvement of 1 or 2 extra-ocular muscles. The radiological status of affected muscles does not normalize, even in the very long term.
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Affiliation(s)
- Ch Daumerie
- Department of Endocrinology Université catholique de Louvain, St-Luc University Hospital, 1200 Brussels, Belgium.
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Sood A, Sood V, Sharma DR, Seam RK, Kumar R. Thyroid scintigraphy in detecting dual ectopic thyroid: a review. Eur J Nucl Med Mol Imaging 2008; 35:843-6. [PMID: 18175113 DOI: 10.1007/s00259-007-0672-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Ectopic thyroid glands are generally a rare entity appearing mostly in the cervical midline (90% of the cases) and even more rarely in other anatomical sites (10%). We present the case of an ectopic submandibular thyroid gland. An 81-year-old woman was referred to our department with a history of right-sided submandibular swelling. Preoperative FNA revealed benign ectopic thyroid tissue. The patient was submitted to resection of the mass. Histological examination of the specimen confirmed the diagnosis. A substitution treatment with thyroxin was initiated postoperatively, as this was the only functional thyroid tissue. Review of the literature revealed 18 similar cases. Physicians should be aware of the possibility that a submandibular swelling could be an ectopic thyroid gland. This entity poses specific diagnostic and therapeutic difficulties. Thorough preoperative diagnostics and resection of the ectopic tissue guarantee a good outcome.
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Affiliation(s)
- Juergen Zieren
- Department of General, Visceral, Vascular and Thoracic Surgery, Universitätsmedizin Berlin, Charité Campus Mitte, Humboldt University of Berlin, Charitéplatz 1, 10117 Berlin, Germany.
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