A case report of coexistence of ectopic lingual thyroid with hypoplastic normal thyroid gland.

Ectopic lingual thyroid along with a normally located thyroid gland is an uncommon condition caused by an aberrant descent of thyroid during embryogenesis. It is more common among females and expresses during puberty, pregnancy and menopause. It is mostly associated with hypothyroidism. Patient usually presents with complaints of dysphagia, dysphonia and suffocation. Treatment of choice depends upon the primary complaint of the patient. We present the case of a young female who underwent tracheostomy to relieve respiratory tract obstruction during puberty and was later diagnosed as a case of ectopic lingual thyroid by radioactive iodine uptake and CT scan imaging. She had an associated hypothyroidism; patient was then put on thyroxine and after making her euthyroid she was operated by transoral route and her ectopic lingual thyroid was removed. She was discharged on a maintenance dose of thyroxin.

Resección transoral endoscópica de tiroides lingual / Endoscopic transoral resection of lingual thyroid

La presencia de tejido tiroideo ectópico en la base de la lengua es muy infrecuente, y la mayoría de los pacientes tienen hipotiroidismo. La indicación de tratamiento depende de la presencia o no de síntomas; la cirugía es la primera elección. Diversas técnicas quirúrgicas han sido descriptas, pero para nosotros el abordaje transoral con endoscopios constituye la mejor opción, por la buena exposición y la mínima morbilidad que produce. Se describe el caso clínico de una mujer que consultó por odinofagia, con diagnóstico de tiroides lingual y que fue tratada con éxito mediante un abordaje transoral con asistencia de endoscopios. (AU)

The presence of ectopic thyroid tissue at the base of the tongue is very rare, and most patients have hypothyroidism. The indication of treatment depends on the presence or not of symptoms, surgery being the first choice. Various surgical techniques have been described, being for us the transoral approach with endoscopes the best option, due to the good exposure, and minimum morbidity that it produces. The clinical case of a woman who consulted for odynophagia, with a diagnosis of lingual thyroid and who was successfully treated by a transoral approach with endoscopic assistance is described. (AU)

Large mass on base of tongue. Diagnosis: lingual thyroid.

Our patient's tongue mass hadn't bothered her until she became pregnant; that's when it got larger and caused problems swallowing and breathing. A simple test confirmed our suspicions.

Computed tomographic angiography study of the relationship between the lingual artery and lingual markers in patients with obstructive sleep apnoea.

AIM: To determine the relationship between the lingual artery and lingual markers for preoperative evaluation of the lingual artery in patients with obstructive sleep apnoea/hypopnoea syndrome (OSAHS). METHODS: A 16-section computed tomographic angiography (CTA) of the lingual artery was performed in 87 inpatient cases with OSAHS, from December 2007 to May 2009. The course of the lingual artery and the anatomic relationship between the lingual artery and the lingual markers were analyzed using CTA imaging. RESULTS: The course of the lingual artery with the tongue in a resting position was similar to that of the Big Dipper constellation (Plough) in the sagittal view of CTA imaging. The first segment of the lingual artery declined approximately 19.27 ± 5.24 mm, the middle segment of the lingual artery was forward approximately 19.30 ± 6.79 mm, and the ascending segment of the lingual artery rose approximately 52.49 ± 10.98 mm. The entry point where the lingual artery entered into the tongue was adjacent to the tip of the greater horn of the hyoid bone. The relationship between the second segment of the lingual artery and the greater horn of the hyoid bone was relatively steady with the tongue in whatever position. The interval between the bilateral greater horn of the hyoid bone equalled that between the bilateral lingual arteries. CONCLUSIONS: Recognizing some lingual markers in the patients with OSAHS, such as the greater horn of the hyoid bone, foramen cecum, circumvallate papilla, lingual vein and tongue midline, may facilitate the surgeon's ability to define the course of the lingual artery accurately in the treatment of OSAHS.

Lingual thyroid in adults: management algorithm based on swallowing outcomes.

OBJECTIVE: To review the presentation, workup, and functional outcomes of adult patients diagnosed with lingual thyroid treated by transoral subtotal excision. These results were then used to formulate a management algorithm. DESIGN: Retrospective chart review (2001-2008). SETTING: Tertiary care academic hospital. PATIENTS: All patients diagnosed with a lingual thyroid as an adult were identified in the University of Alberta's head and neck mass database. Charts were reviewed for initial presentation, diagnostic methods, radiographic findings, and treatment and follow-up results. INTERVENTION: Transoral subtotal excision of lingual thyroid tissue. MAIN OUTCOME MEASURE: Postoperative swallowing function as measured by pharyngeal residue and aspiration on videofluoroscopic swallowing studies. RESULTS: Five patients with lingual thyroids meeting the study criteria were identified. All were females aged 29 to 58 years (mean 44 years). Presentations ranged from asymptomatic to acute airway obstruction. Diagnosis was made with flexible nasopharyngoscopy, thyroid scintigraphy, and computed tomography. All patients underwent transoral subtotal excision of their thyroids with either a CO2 laser or electrocautery. Two patients complained of residual symptoms and received adjunctive 131I, which led to symptom resolution. Pathologic evaluation revealed benign thyroid tissue. Swallowing function remained efficacious and safe in all patients, as shown by a lack of aspiration and low pharyngeal residue scores. These results were used to propose a management algorithm for the spectrum of adult-diagnosed lingual thyroid presentations. CONCLUSIONS: Transoral subtotal excision of lingual thyroid glands provides adequate resection of the lesion with good postoperative swallowing function. When appropriate, this is advocated as the treatment modality of choice.

Tiroides lingual: un hallazgo casual / Lingual thyroid: an accidental finding

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[Lingual thyroid--case report: a woman with a tumor at the base of the tongue]. / Tungurótarskjaldkirtill (lingual thyroid) -- sjúkratilfelli: kona meeth fyrirfereth í tungurót.

We report a case of lingual thyroid. A woman presented with a few years history of mild dysphagia, cough and uncomfortable breathing when going to sleep at night. Laryngostroboscopy showed a mass lesion at the base of the tongue. A CT scan and thyroid scanning revealed a bilobar mass of thyroid tissue, compatible with a lingual thyroid. No thyroid gland was found at its usual location. The woman was euthyroid and since her symptoms were mild she was treated with thyroxin and observation. Lingual thyroid is a rare phenomenon caused by abnormal migration of thyroid cells during the first weeks of fetal life. Females are affected more often than males and although this condition is often asymptomatic, symptoms can occur, most often during puberty, pregnancy and menopause. On examination a mass is noted at the base of the tongue and the diagnosis is then confirmed with CT/MRI and thyroid scanning. Treatment can vary from observation to thyroxin medication, radioactive iodine and complicated surgical intervention, depending on the symptoms and the overall health of the patient.