Case Report
Conservative Management for Lingual Thyroid Ectopic
Eder Alberto Sigua-Rodriguez,
1
Douglas Rangel Goulart,
1
Luciana Asprino,
1
and Afonso Celso de Moraes Manzano
2
1
Oral and Maxillofacial Surgery Division, Department of Oral Diagnosis, Piracicaba Dental School,
State University of Campinas (UNICAMP), Campinas, SP, Brazil
2
Department of Head and Neck Surgery, Hospital Santa Casa de Limeira, Limeira, SP, Brazil
Correspondence should be addressed to Eder Alberto Sigua-Rodriguez; edersiguaodont@gmail.com
Received 25 September 2014; Revised 27 December 2014; Accepted 11 January 2015
Academic Editor: Augusto Casani
Copyright © 2015 Eder Alberto Sigua-Rodriguez et al. Tis is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Lingual thyroid gland is a rare clinical entity. Te presence of an ectopic thyroid gland located at the base of the tongue may be
presented with symptoms like dysphagia, dysphonia, and upper airway obstruction. We are introducing a case of an 8-year-old girl
who had lingual thyroid that presented dysphagia and foreign body sensation in the throat. Te diagnostic was reached with clinical
examination, thyroid scintigraphy with Tc
99m
and ultrasound. A laryngoscopy was performed which confrmed a spherical mass
at base of tongue. Investigation should include thyroid function tests. In this case we observed subclinical hypothyroidism. Tere
are diferent types of surgical approaches for the treatment of this condition; however, the treatment with Levothyroxine Sodium
allowed the stabilization of TSH levels and clinical improvement of symptoms in a follow-up of 2 years.
1. Introduction
Ectopic thyroid is an uncommon embryological abnormality
characterized by the presence of thyroid tissue in a site
other than its usual pretracheal location [1, 2]. Of all ectopic
thyroids 90% are found to be lingual [3] It is a rare congenital
anomaly appearing with prevalence of 1 : 100.000 [3].
Patients with lingual thyroid tissue usually present with
symptoms such as dysphagia, choking, hemorrhage, and dys-
pnea and occasionally life-threatening airway obstruction. In
addition, malignant transformation of the lingual thyroid has
been reported, albeit rarely [4]. For patients with obstructive
symptoms, thyroxine replacement should be introduced as
initial therapy, to induce glandular shrinkage [5]. If conser-
vative treatment fails, surgical removal is necessary [4].
Lingual thyroid is estimated to occur in 0.2 per cent of
normal children, being more common in females and on
the lef side of the thyroid gland [1]. In this case report, the
diagnosis and conservative treatment of this condition are
highlighted.
2. Case Report
A child of eight years old came to our department with
dysphagia and foreign body sensation in the throat. Tese
symptoms were present to three months and showing greater
intensity every day. She had no history of either past or
present thyroid disease. Afer examination, the patient pre-
sented a solid, spherical mass with 2 cm of diameter, covered
with intact mucosa, located at the base of the tongue. Exam-
ination of neck did not reveal cervical lymphadenopathy, the
past medical history of the patient was insignifcant, and she
was not currently taking any medication.
Tyroid scintigraphy with Tc
99m
and ultrasound were
performed, which confrmed oval mass in the base of tongue,
suggestive of ectopic thyroid tissue (Figures 1 and 2). Laryn-
goscopy was performed and showed the presence of a mass at
the base of the tongue with displacement of the uvula.
Tyroid hormone tests showed elevated thyroid-
stimulating hormone (TSH = 10.79 (0.4–4.2)) concentrations
and normal T4 concentrations (T4 = 0.81 (0.61–1.48)). From
the clinical and imaging fndings the diagnostic of ectopic
Hindawi Publishing Corporation
Case Reports in Otolaryngology
Volume 2015, Article ID 265207, 4 pages
http://dx.doi.org/10.1155/2015/265207