Case Report

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

Abstract

Introduction

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.

Case presentation

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.

Conclusion

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.

Key words

ectopic thyroid; lingual thyroid; CT angiography

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