Endocrine Abstracts

Ectopic thyroid is a rare developmental anomaly of the thyroid gland which is defined as the presence of thyroid tissue at a site other than the pretracheal area. Nearly 1–3% of all ectopic thyroids are located in the lateral neck. Simultaneous submandibular ectopic thyroid tissue presenting with a functional orthotopic thyroid gland is extremely rare. A 37-year-old woman was admitted to our outpatient clinic with a cervical mass existing for 3 years. On physical examination, a painless, uniformly bounded, mobile, soft, nearly 3×4 cm mass was observed in the right submandibular region. A detailed systemic examination did not reveal any abnormality. Ultrasonography of the neck demonstrated a solid mass of 34×36×26 mm, including cystic areas and showing significant blood flow, localized in the right submandibular region. Her thyroid gland was in a normal location and had normal parenchyma. Thyroid function tests confirmed euthyroidism and she had no anti-thyroperoxidase or antithyroglobulin antibodies. Ultrasonographyguided fine needle aspiration biopsy was non-diagnostic. Cervical magnetic resonance imaging revealed a 35×41×26 mm lobulated mass showing contrast agent involvement in the right submandibular region and a normal orthotopic thyroid gland. The patient underwent excision of the submandibular mass under general anaesthesia. The histopathological examination of the mass revealed thyroid gland tissue with nodular hyperplasia. She was symptom free and euthyroid over the next year and there was no evidence of recurrence. Ectopic submandibular thyroid tissue is an extremely rare event that poses both diagnostic and management problems. However, physicians should be aware of the possibility that a submandibular mass could be ectopic thyroid tissue.