A Case of Ectopic Lingual Thyroid: The Importance of Preoperative Vascular Evaluation
Nicolas Sigaux, Pierre Philouze, Alexis Ambrun, Frédérique Le Breton, Françoise Borson-Chazot and Jean-Christian Pignat
World Journal of Medical and Surgical Case Reports 2014, 3:15
Symptomatic ectopic lingual thyroid is a rare condition. The purpose of our work is to demonstrate the importance of an accurate clinical, biological and radiological evaluation, in order to decide when and how to treat.
A 55 year old male patient with no history of dysthyroidism presented in outpatient clinic for the management of intermittent episodes of mouth bleeding complicated with anemia. The nasopharyngoscopy revealed a thyroid-looking lump at the base of the tongue, pushing down the epiglottis. Thyroid stimulating hormone was slightly elevated. Technetium-99m scintigraphy and ultrasonography confirmed the absence of thyroid tissue in normal position. CT scan showed a 38x32x16 mm mass, vascularized by a single ectopic artery coming from the right external carotid artery. After 4 years of suppressive medical therapy, a surgical excision was realized with a cervical approach. Safe vascular control of the ectopic gland was guaranteed by CT angiography.
Surgical management of ectopic lingual thyroid is often decided after medical treatment's failure. It requires a precise radiological evaluation, including a CT angiography, looking for an ectopic vascularization and helping to choose the safest surgical approach.
ectopic thyroid; lingual thyroid; CT angiography