Lingual thyroid causing dysphagia and dyspnoea. Case reports and review of the literature

Abstract

Lingual thyroid is a rare embryological anomaly and originates from failure of the thyroid gland to descend from the foramen caecum to its normal eutopic pre-laryngeal site. The ectopic gland located at the base of the tongue is often asymptomatic but may cause local symptoms such as dysphagia, dysphonia with stomatolalia, upper airway obstruction and haemorrhage, often with hypothyroidism. Two cases are presented, one in a 62-year-old female and the other in a 42-year-old female, both of whom complained of sensation of a foreign body and progressive dysphagia and dyspnoea caused by ectopic lingual thyroid. Treatment was performed with a partial endoscopic removal and an external cervical approach, followed by substitutive hormone treatment, respectively. Diagnostic procedures and therapeutic options are discussed and a review has been made of reports of lingual thyroid appearing in the literature.

Keywords: Dysphagia; Dyspnoea; Ectopic thyroid; Lingual thyroid.

Fig. 1

CT scan with i.v. contrast showing a well-defined mass 41 x 36 x 47 mm in size (Case 1) and with distinct margins localized at base of tongue.

Fig. 2

CT scan shows aberrant thyroid tissue as a high density mass in region of tongue (Case 2). Following i.v. injection of iodine material, mass showed homogeneous contrast enhancement.