Endocrine Abstracts

Case: A 34-year-old, Saudi male, known case of hypothyroidism with coarse (potato) voice, referred for isotopic thyroid scan. After withdrawing the Eltroxin for one month, thyroid scan was done and showed abnormal uptake rounded in shape and appears bi-lobar, seen highly in the neck, at the midline, between both submandibular glands. No evidence of any uptake at the normal anatomical position of the thyroid gland. Ultrasound of the neck was done and showed large submental mass. Patient was referred for CT scan with contrast of the neck that showed large midline suprahyoid mass lesion, mildly calcified measuring 70×54×50 mm, that showing heterogeneous enhancement post contrast. An ectopic goitrogenic lingual thyroid tissue was the first impression diagnosis; underlying malignancy cannot be totally excluded. Patient was referred for MRI of the neck four months later by his treating physician that showed no interval changes regarding the size and extension of the mass.

Unfortunately, there was no feedback from the treating physician. Only lately I was informed that the patient was operated and the large lingual mass was excised, and the pathology result came to be an abnormal thyroid tissue. Patient recovered his voice and obviously he is under Eltroxin treatment.

Discussion: The thyroid scan plays most important role in diagnosing thyroid ectopy.

Other X-ray modalities are contributing and mandatory in some cases.

Lingual thyroid is the most frequent location of ectopy.