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Ectopic Thyroid tissue after total thyroidectomy
Introduction The ectopic thyroid tissue ETT is a rare congenital anomaly as the thyroid tissue not located antero-laterally from the second to the fourth tracheal cartilage. The ETT may be the only functioning thyroid tissue or may coexist structure with a normally located thyroid gland. Hypothyroidism is more common than hyperthyroidism Case presentation
A 32-year-old female patient presented in our department to remove a level II neck mass. this mass existed for more than 5 years, an exophthalmus was clinically noticeable. she had undergone total thyroidectomy in 2008. She takes no thyroid hormones substitution
MRI findings round lesion located on the left level II of neck . sonography shows up a hypoechoic hypervascularized Mass . The scintigraphy showed a left high cervical enreichment typical of a tyroid tissue. In the original position of the thyroid gland no tissue was detectable.
Because of these findings, surgical removal was not necessary.
Therapy Initiation of thyroid hormone replacement at 75 μg / day and control of TSH after 4-6 weeks, as well as a cardiac consultation including echocardiography to assess cardiac pathology during long-term hypothyroidism, were recommended.
Conclusion Ectopic thyroid gland tissue can occur either as the only detectable thyroid gland tissue or in addition to a normotopic thyroid gland. After a total thyroidectomy TSH can induce a compensatory volume increase of previously asymptomatic ectopic tissue. This hyperplastic ectopic tissue can occur as an unclear cervical space-occupying lesion.
Prior to surgical exploration of an unclear cervical mass the possibility of ectopic thyroid tissue should be included in the differential diagnostic considerations.
Article published online:
10 June 2020
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