Session: SAT 449-497-Thyroid Neoplasia & Case Reports
Poster Board SAT-454
A 61 years old woman came to our attention for asthenia and dizziness. She complained defluvium and psoriasis and she had hypertension and osteoporosis treated respectively with ACE-inhibitors and bisphosphonates. Until then she had never performed thyroid function tests or thyroid ultrasound. Family history was negative for endocrine disease while biochemical evaluation revealed subclinical hypothyroidism (TSH 8.5 µU/ml, FT4 9.7 pg/ml) without other pathological findings. Anti thyroglobulin and anti thyroperoxidase autoantibodes were negative, while thyroid ultrasound showed athyreosis in anterior neck. Therefore, thyroid scintigraphy was performed showing a focal uptake near the left submandibular gland. Ultrasound focused study confirmed, next to left submandibular gland caudal margin, an ectopic thyroid tissue of about 3 cm. The ectopic thyroid had normal echo pattern except a hypoechoic micronodule of about 1 cm. Fine needle aspiration biopsy was performed showing benign findings (Thy 2). Thus, patient started levothyroxine therapy with periodic biochemical and clinical assessment.
This case represents a rare condition of thyroid dysgenesis. Ectopic thyroid tissue has been described in several sites, as foramen caecum, base of the tongue, mediastinum or distant subdiaphragmatic areas. A lateral ectopic thyroid gland, in particular in submandibular region, could occur very rarely when the cells of the lateral anlage do not join those of the median. Patients usually present with a lateral, palpable, mobile, painless mass in the carotid triangle or the submandibular area. In our case, patient was asymptomatic and diagnosis was performed only on the basis of subclinical hypothyroidism.
Nothing to Disclose: RMP, RML, AP, SMC
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