Lingual thyroid

Lingual thyroid is an uncommon entity (Incidence: 1 per 10,000 individuals). The first case was noted in 1869 by Hickmann. In 1972, a total number of 373 cases were collected from the world literature. Because of the rarity and the suprahyoid approach of Operation Choosen, this case is reported.     

Lingual thyroid carcinoma with nodal metastasis

OBJECTIVES: To discuss treatment options and surgical management of lingual thyroid carcinoma with cervical metastasis. STUDY DESIGN: Lingual thyroid is relatively uncommon, and carcinoma of the lingual thyroid is extremely rare, with only 40 cases reported. We report a new case of a young female who presented with a cervical neck mass found to represent metastatic papillary thyroid carcinoma. Further workup revealed the patient's only thyroid tissue was located at the tongue base and was the site of the primary tumor. Management of lingual thyroid carcinoma and review of the literature is discussed. METHODS: A case report and review of the literature of lingual thyroid carcinoma. RESULTS: A young female presented with a left neck mass diagnosed as metastatic papillary thyroid carcinoma. Review of the computed tomography scan of the neck revealed a tongue base mass, absence of an othotopic thyroid gland and bilateral cervical lymphandenopathy. Bilateral selective neck dissections with removal of the tongue base lesion confirmed the diagnosis of lingual thyroid carcinoma with multiple left cervical nodal metastases. CONCLUSIONS: A case of lingual papillary thyroid carcinoma with cervical metastasis is reported. Treatment is best managed with surgical excision of all thyroid tissue followed by radioactive iodine ablation. Surgical approaches to the tongue base need to be considered based on the size of the lingual primary tumor and the need to address lymph node metastases gland. This is the first reported case in the literature of lingual papillary thyroid carcinoma presenting with cervical nodal metastasis in a female with absence of an orthotopic thyroid gland. This is also the first report to show that papillary and not follicular cell carcinoma is the predominating histopathology in lingual thyroid carcinoma.     

Lingual thyroid in children: a rare clinical entity

Objectives/Hypothesis: To study the presentation, management, and long‐term outcome of children presenting with lingual thyroid. Study Design: Institutional review board approved, retrospective study (1993–2004). Methods: The study was conducted at a tertiary care pediatric medical center. The main outcomes measured were initial presentation, radiographic findings, endocrine evaluation, surgical outcome, pathologic features, complications, need for hormonal replacement. Results: Four patients presented to the Department of Otolaryngology and Communications Enhancement, Children's Hospital Boston with lingual thyroid between 1993 and 2004. All patients were female, with an age range of 2 to 12 years (x = 6). All patients presented with a mass (1.4–3.5 cm) and most with respiratory or feeding difficulty. Magnetic resonance imaging was obtained in three patients and revealed a mass consistent with lingual thyroid. Thyroid scan confirmed the lingual thyroid as the only functioning thyroid in all four patients. None of the patients responded to hormonal replacement, and all underwent surgical excision of the mass. Surgical approach included midline glossotomy (n = 2) and CO₂ laser excision (n = 2). Pathologic evaluation confirmed lingual thyroid in all four patients. No evidence of malignancy was seen in any patient. All four patients require lifelong hormonal replacement. Conclusions: Lingual thyroid is a rare condition, with an incidence of 1:100,000. This infrequent congenital anomaly is often asymptomatic until a pathologic stress such as systemic disease or physiologic stress such as puberty causes enlargement of the ectopic tissue, leading to dysphagia, dysphonia, and dyspnea. The work‐up should include routine blood work including thyroid function tests thyrotropin, thyroxine, and thyroid hormone binding ratio; iodine thyroid scintigraphy; and computerized tomography or magnetic resonance imaging. The majority of patients require surgical excision of the symptomatic mass and, in case of absence of orthotopic thyroid tissue, long‐term thyroid hormone replacement.     

Lingual thyroid. Case report and review of the literature

A case of a lingual thyroid gland in the absence of orthotopic thyroidal tissue is reported. Presenting symptoms, diagnostic methods, differential diagnosis, treatment modalities, and prognosis are discussed.     

Lingual thyroid: the diagnostic value of magnetic resonance imaging

Lingual thyroid is an uncommon developmental aberration of embryogenesis. It may present as a mid-line, non-tender, painless, reddish appearing swelling in the throat. Magnetic resonance imaging (MRI) is a relatively new diagnostic method for this condition. Two cases of lingual thyroid are reviewed with their MRI's and surgical results.     

Lingual thyroid: iodine 131: a viable treatment modality revisited

PURPOSE: Lingual thyroid has a reported incidence between 1:10 and 1:100,000. When symptomatic, patients may present with dysphagia, choking, and/or dyspnea. Current surgical treatment options range from tumor extirpation or transposition to excision and reimplantation. Tracheotomies are often performed postoperatively for reliable airway control. Iodine 131 (131I) has not been a popular modality of treatment for lingual thyroid because of theoretical fears of increased airway obstruction from thyroiditis. We believe that these fears were not substantiated, and that symptomatic patients needed a reliable, nonsurgical treatment option. Therefore, our goal was to further investigate the use of 131I for the treatment of symptomatic lingual thyroid. PATIENTS AND METHODS: A 6-year retrospective chart review was performed. From 1994 to 2000, 2 patients with symptomatic lingual thyroid presented to the Arkansas Cancer Research Center Head and Neck Oncology clinic, University of Arkansas for Medical Sciences, Little Rock, AR. Patients underwent pretreatment computed tomography, and iodine 123 scans. They then received 1 oral dose of 131I. Doses ranged from 30 to 85 mCi. Patients were then followed daily for signs of airway compromise. RESULTS: Complete resolution of symptoms was seen 2 months after treatment. Patients did not complain of any increased airway compromise during treatment initiation. Patients remain symptom-free and are maintained on thyroid hormone replacement. CONCLUSIONS: Iodine 131 ablation of lingual thyroid is a safe and effective treatment in symptomatic patients and should be included in the algorithm when formulating a treatment plan.     

Lingual thyroid. Case report and review of the literature.

We review the world literature on lingual thyroid. One of our cases of lingual thyroid is added to this body of information specifically because of the patient's unusual lack of any response to hormonal suppression treatment. This behavior was suggestive of a malignant neoplasm and was, in our opinion, indication for excisional biopsy, even without any of the usual symptoms associated with lingual thyroid. To our knowledge, this behavior has not been previously reported.     

舌根异位甲状腺的诊断及处理-附3例报告

异位甲状腺是一种胚胎发育异常性疾病,可发生于不同部位.舌甲状腺系位于舌根中部的异位甲状腺,舌根异位甲状腺非常罕见,有报道其临床发病率为1:3 000～1:100 000.尽管可伴有其它部位的甲状腺存在,但70%的舌甲状腺是唯一的功能甲状腺,临床上若有误切,必然造成患者终生服用甲状腺素的后果,应引起广大同仁的重视.舌根甲状腺常出现的症状是咽下困难、发音改变、呼吸困难、咽部异物感和舌根甲状腺出血,但大多数情况下,舌根甲状腺是无症状的.诊断主要是依靠临床和实验室检查,放射性甲状腺扫描等.舌甲状腺治疗方法的选择依赖于诸多因素,并且由于此病临床罕见,有关报道很少,故尚无一规范的治疗手段.本文报道3例舌甲状腺患者的诊治过程,并对有关文献进行了复习.     

Lingual osteoma

The 29th patient with a lingual osteoma is presented. This is the first case, to our knowledge, with preoperative radiographic and computed tomographic documentation. This rare, benign tumor almost always occurs as a pedunculated solitary mass that arises from the posterior tongue near the foramen cecum. The patients are usually young women who complain wf dysphagia or fullness in the base of the tongue. The imaging findings and theories of the origin of this tumor are described.     

Lingual chondroma

In this article we report a case of chondroma which occurred in the lateral margin of the tongue of a 61-year-old male, briefly describing its clinical and pathologic features--including immunohistochemical findings--and reviewing the literature. There are only about twenty-five reported cases of this rare tumor in the literature, and the vast majority of them appeared in younger patients.     

Lingual abscess

The unilateral abscess of the anterior portion of the tongue is an extremely rare occurrence. We report a case in which we have used the ultrasonography in the diagnosis, and discuss, as etiologic hypothesis the participation of Blandin-Nühn glands in the genesis of these abscess.