Endocrinol Metab.  2012 Dec;27(4):303-307. 10.3803/EnM.2012.27.4.303.

A Case of Lingual Thyroid Treated by 131I Ablation

• Yeon MH
• Choi YH
• Choi YR
• Park WR
• Choi HJ
• Oh TK
• Jeon HJ

• KMID: 1973794
• DOI: http://doi.org/10.3803/EnM.2012.27.4.303

Abstract

A lingual thyroid is a rare developmental anomaly caused by the failure of the descent of the thyroid gland anlage early in the course of embryogenesis. The incidence of lingual thyroid has been reported to be 1/100,000. Lingual thyroid is often asymptomatic but may cause dysphagia, dysphonia, upper airway obstruction and hemorrhage. In this report, we described the case of a 50-year-old women experiencing lingual thyroid who had subclinical hypothyroidism. She underwent successful 131I ablation and has done well on thyroid hormone replacement therapy.

Keyword

Hypothyroidism; Lingual thyroid; Radiotherapy

MeSH Terms

Airway Obstruction
Deglutition Disorders
Dysphonia
Embryonic Development
Female
Hemorrhage
Hormone Replacement Therapy
Humans
Hypothyroidism
Incidence
Lingual Thyroid
Middle Aged
Pregnancy
Thyroid Gland

Figure

• 

  Fig. 1 Neck computed tomography (CT) images. (A) Axial CT image of the neck revealed the absence of thyroid gland at the normal anatomical location. (B, C) CT of the neck revealed 2.6 × 2.9 × 3.5 cm sized well-defined solid and cystic mass at posterior aspect, mid-line portion of tongue.

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  Fig. 2 Histopathologic finding (H&E stain, × 100). Microscopic examination of biopsy specimen showed degenerative varying size follicles lined by some atypical epithelial cells and stromal hyalinization.

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  Fig. 3 131I scan showed one focal iodine uptake in tongue base which is suggestive of lingual thyroid.

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  Fig. 4 131I whole body scan. Anterior and posterior 131I whole body scan showed focal iodine uptake (arrows) in mid portion of tongue base area. The scan was performed after the radioactive iodine therapy.

Reference

1. Hickman W. Congenital tumor of the base of the tongue pressing down the epiglottis on the larynx and causing death by suffocation sixteen hours after birth. Trans Pathol Soc Lond. 1869. 20:160–163.

2. Weider DJ, Parker W. Lingual thyroid: review, case reports, and therapeutic guidelines. Ann Otol Rhinol Laryngol. 1977. 86(6 Pt 1):841–848.

3. Rahbar R, Yoon MJ, Connolly LP, Robson CD, Vargas SO, McGill TJ, Healy GB. Lingual thyroid in children: a rare clinical entity. Laryngoscope. 2008. 118:1174–1179.

4. Kim BJ, Chun JB, Jung EJ, Han SW, Cynn KS. A case of lingual thyroid. Korean J Otolaryngol-Head Neck Surg. 1984. 27:308–311.

5. Yun JB, Jang HK, Yoo YS. Two cases of lingual thyroid. Korean J Otolaryngol-Head Neck Surg. 2000. 43:1008–1011.

6. Min BS, Ju JW, Han SH, Shin YD, Jung TW, Kim YH. Unexpected difficult intubation due to lingual thyroid: a case report. Korean J Anesthesiol. 2006. 51:236–238.

7. Kuehn P, Newell RC, Reed JF. Exophthalmos in a woman with lingual, subhyoid and lateral-lobe thyroid glands. N Engl J Med. 1966. 274:652–654.

8. Ryu IS, Choi SH. A case of transoral excision using CO2 laser in management of lingual thyroid with oral bleeding. Korean J Otorhinolaryngol-Head Neck Surg. 2010. 53:99–102.

9. Kansal P, Sakati N, Rifai A, Woodhouse N. Lingual thyroid. Diagnosis and treatment. Arch Intern Med. 1987. 147:2046–2048.

10. Sauk JJ Jr. Ectopic lingual thyroid. J Pathol. 1970. 102:239–243.

11. Pérez JS, Muñoz M, Naval L, Blasco A, Diaz FJ. Papillary carcinoma arising in lingual thyroid. J Craniomaxillofac Surg. 2003. 31:179–182.

12. Bukachevsky RP, Casler JD, Oliver J, Conley J. Squamous cell carcinoma and lingual thyroid. Ear Nose Throat J. 1991. 70:505–507.

13. Farrell ML, Forer M. Lingual thyroid. Aust N Z J Surg. 1994. 64:135–138.

14. Park HM, Gupta S, Skierczynski P. Radioiodine-131 therapy for lingual thyroid. Thyroid. 2003. 13:607.

15. Danner C, Bodenner D, Breau R. Lingual thyroid: iodine 131: a viable treatment modality revisited. Am J Otolaryngol. 2001. 22:276–281.

16. Iglesias P, Olmos-García R, Riva B, Diez JJ. Iodine 131 and lingual thyroid. J Clin Endocrinol Metab. 2008. 93:4198–4199.

17. Cunningham CL, Vilela RJ, Roy S. Radiofrequency ablation as a novel treatment for lingual thyroid. Int J Pediatr Otorhinolaryngol. 2011. 75:137–139.