Endocrine Abstracts (2013) 32 P318 | DOI: 10.1530/endoabs.32.P318

Never too late to discover some extra thyroid tissue

Ana Wessling1, Jose Maria Araguéz1,2, Florbela Ferreira1 & Isabel Carmo1,2


1Endocrinology Department of Santa Maria University Hospital, Lisbon, Portugal; 2Faculty of Medicine, University of Lisbon, Lisbon, Portugal.


Introduction: Ectopic thyroid is a rare entity, resulting from developmental defects at early stages of thyroid embriogenesis. It’s prevalence is 1/100 000–300 000 in general population and 1/4000–8000 in patients with thyroid disease. This condition is more common in females, in Asians and may occur at any age, although it’s most common at younger ages. The most frequent location of ectopic thyroid tissue is at the base of the tongue. In 70–75% of cases is the only thyroid tissue present. The mean age of presentation is at 40.5 years. The most common symptoms are related to the growth of lingual thyroid (dysphagia, disphonia, sleep apnea and in more severe cases respiratory obstruction and hemorrhage) and hypothyroidism, especially in the absence of orthotopic thyroid.

Case report: We present a case from a Caucasian white male, 82 years, assymptomatic, with subclinical hypothyroidism diagnosed at routine clinical evaluation. The Ultrasound scan shwowed a decreased size thyroid gland and head and neck CT, ordered because of other clinical problems showed a 25 mm sublingual thyroid gland, confirmed by Scintigraphy. He also did a Laringoscopy wich confirmed a well defined sublingual mass. He was medicated with L-thyroxine and as he kept asymptomatic no other treatment was needed.

Conclusion: This case shows a case of a caucasian male patient with a rare congenital condition, more common in Asian women. He had a lingual ectopic gland and also a orthotopic thyroid, which only happens in 25–30% of these cases. This is probably the main reason why he kept assymptomatic most of his life, until the age of 82 (mean age of diagnosis 40.5 years) and his clinical presentation consisted only in a subclinical hypothyroidism. So, in clinical practice we should be carefull precluding any condition just based on probability.

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