Dual ectopic thyroid: a case report with review of literature

Abstract

The ectopic thyroid gland is a rare entity which is mostly found along the line of descent of the thyroid gland. Most of the patients present with midline swelling and usually seek medical attention. Dual ectopic thyroid gland is even rarer. The clinical examination and different imaging modalities establish its diagnosis. Radionuclide studies are highly sensitive and specific in demonstrating the functional tissues in patients with ectopic thyroid, thereby guiding further management. The authors reported a case of ectopic thyroid gland in a girl with midline neck swelling initially, subsequently lost to follow-up. She again presented with enlarged swelling after a period of three years with dual ectopic thyroid in the neck region on thyroid scan. Thyroid scintigraphy demonstrated that progression in the size of ectopic glands was due to neglect in treatment.

Keywords: Dual Ectopic Thyroid; Subclinical Hypothyroidism; Tc-99m Pertechnetate Scan.

Fig. 1

A 5-year-old girl with neck swelling.( A. Clinical photograph shows the midline neck swelling. B. Tc-99m pertechnetate thyroid scan shows a focus of abnormal radiotracer uptake in the subhyoid region and another very faint focal uptake in the sublingual region without any evidence of radiotracer uptake in the normal thyroid position in the anterior view.)

Fig. 2

The same patient at the age of 8 years with neck swelling.( Clinical photographs show the midline neck swelling (A) and oral cavity swelling (arrow). (B) Tc-99m pertechnetate thyroid scan shows two foci of abnormal radiotracer uptake in the sublingual and subhyoid regions with no evidence of radiotracer uptake in the region of normally placed thyroid in lateral (C) and anterior views (D).)