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Simultaneous occurrence of a thyroglossal duct cyst and a lingual thyroid in the absence of an orthotopic thyroid gland

  • J Madana (a1), R Kalaiarasi (a1), D Yolmo (a1) and S Gopalakrishnan (a1)

Abstract

Objective:

We report an extremely rare case of the simultaneous occurrence of a thyroglossal duct cyst and a lingual thyroid in the absence of an orthotopic thyroid gland, in a seven-year-old girl from South India.

Method:

Case report and a review of the English language literature on the subject.

Results:

The patient presented with a mass on the tongue that had been present for three years, and an anterior neck swelling that had been present for two years. Examination revealed a midline, pinkish, firm mass present on the posterior one-third of the tongue. The neck showed a midline cystic swelling in the infrahyoid position. Radiological imaging confirmed the clinical findings, revealing the absence of her thyroid gland in the normal location. Sistrunk's procedure was performed leaving behind a lingual thyroid. At 13-month follow up, the patient was euthyroid with no recurrence.

Conclusion:

To our knowledge the association of a lingual thyroid and a thyroglossal cyst has only been reported once in the literature. The presence of a lingual thyroid in the absence of a normally located thyroid gland or functioning thyroid tissue along the thyroglossal tract, confirmed by radionuclide and computed tomography imaging, may indicate the failure of the normal descent of the thyroid gland during embryonic development. This probable absence of the descent of the thyroid raises questions regarding the origin of thyroglossal duct cysts.

Copyright

Corresponding author

Address for correspondence: Dr J Madana, Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry – 605006, India E-mail: maddyy@gmail.com

References

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1Madana, J, Yolmo, D, Saxena, SK, Gopalakrishnan, S. True thyroglossal fistula. Laryngoscope 2009;119:2345–7
2McCoul, ED, de Vries, EJ. Concurrent lingual thyroid and undescended thyroglossal duct thyroid without orthotopic thyroid gland. Laryngoscope 2009;119:1937–40
3Danner, C, Bodenner, D, Breau, R. Lingual thyroid: iodine 131: a viable treatment modality revisited. Am J Otolaryngol 2001;22:276–81
4Hickman, W. Congenital tumor of the base of the tongue, pressing down on the epiglottis and causing death by suffocation sixteen hours after birth. Trans Pathol Soc Lond 1869;20:160–1
5Larchelle, D, Arcand, P, Belzile, M, Gagnon, NB. Ectopic thyroid tissue – a review of the literature. J Otolaryngol 1979;8:523–30
6Leung, AK, Wong, AL, Robson, WL. Ectopic thyroid gland simulating a thyroglossal duct cyst: a case report. Can J Surg 1995;38:87–9
7Rojananin, S, Ungkanont, K. Transposition of the lingual thyroid: a new alternative technique. Head Neck 1999;21:480–3
8Skolnik, EM, Yee, KF, Golden, TA. Transposition of the lingual thyroid. Laryngoscope 1976;86:785–91
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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