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. 2022 Dec;74(Suppl 3):5329-5337.
doi: 10.1007/s12070-021-02493-0. Epub 2021 Mar 27.

Management of Lingual Thyroid with Second Thyroid Anomaly: An Institutional Experience

Pradipta Kumar Parida  1 , Karthik Herkel  1 , Chapity Preetam  1 , Pradeep Pradhan  1 , Dillip Kumar Samal  1 , Saurav Sarkar  1
Affiliations

Management of Lingual Thyroid with Second Thyroid Anomaly: An Institutional Experience

Pradipta Kumar Parida et al. Indian J Otolaryngol Head Neck Surg. 2022 Dec.

Abstract

Patients diagnosed with Lingual thyroid (LT) may have second thyroid anomaly (STA).Given rarity of dual ectopics/anomalies, standardized management recommendations are lacking. We aimed to describe our experience in management of LT with STA and suggest a management algorithm. We conducted a retrospectivechart review of patients diagnosed with LT between Jul-2013 and Dec-2019. Data regarding demographics, clinical presentation, endocrine-profile, associated STA treatment received, and outcomes were collected and analyzed. Eight patients (female-7 cases, male-1 case, adult-4 cases, children-4 cases, mean age-18.1 years, range 6-43 years) with LT were identified. Four(50%) cases had STA in addition to LT (thyroglossal cyst in two-cases, sublingual thyroid in one-case and sub-mental thyroid in one-case) and presented as neck mass. Diagnosis was confirmed with flexible-nasopharyngoscopy,ultrasonography,thyroid-scintigraphy and computed-tomography. Ectopic thyroid(s) was/were only functional thyroid gland with absence of normal thyroid in all cases. Two- cases had symptomatic for LT and were managed by coblation assisted excision of LT in one and I131 ablation in one-case.All adult patients were hypothyroidand received thyroxin.All pediatric cases were euthyroidand received no surgical intervention for LT.Three patients required surgery for STA; Sistrunk surgery in two and excision of submental thyroid in one. All cases were asymptomatic. These results were utilized to suggest a management algorithm for LT with STA. LT patients with STA are more symptomatic and required more surgical interventions in compare to isolated LT. When appropriate, excision of STA with/without intervention for LT and thyroxin is advocated as the treatment modality of choice in LT patients with STA.

Keywords: Ectopic thyroid tissue; Hypothyroidism; Lingual thyroid; Sublingual thyroid; Thyro-glossal duct cyst; Thyroid gland.

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Conflict of interest statement

Conflict of InterestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Patient no.4 (a), (b). Computed tomographic (CT) axial section and sagittal CT reconstruction showing lingual thyroid. (c) Tc99-scan (anterior-view) showing dense uptake at tongue base and no uptake in neck. (SSN-suprasternal-notch). (d) surgically excised lingual thyroid
Fig. 2
Fig. 2
Patient no.5 (a) Endoscopic view of lingual thyroid (b). Photograph showing sub-mental swelling caused by sublingual-thyroid. (c), (d). Computed-tomographic (CT): sagittal CT reconstruction and axial section showing dual ectopics;lingual thyroid dual(blue-arrow)and and sublingual thyroid(green-arrow)
Fig. 3
Fig. 3
Management algorithm for (a). Asymptomatic dual thyroid-anomalies. (b) Patient with dual thyroid-anomalies but symptomatic only for lingual-thyroid. (c) Patient with dual thyroid-anomalies but symptomatic only for second thyroid ectopic/anomaly
See this image and copyright information in PMC

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