Assuntos
Cistos/congênito , Doenças da Laringe/congênito , Cistos/diagnóstico por imagem , Cistos/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Doenças da Laringe/diagnóstico por imagem , Doenças da Laringe/cirurgia , Laringoscopia , Terapia a Laser , Tireoide Lingual/diagnósticoRESUMO
We report an 11 year-old boy who presented with difficulty in swallowing without symptoms of hypothyroidism. The physical examination revealed a mass at the base of the tongue. The thyroid hormone profile showed a primary hypothyroidism (a serum TSH of 10.8 IU/mL with normal-low thyroxin of 6.0 microg/dL and low triiodothyronine of 57.8 ng/dL). Antithyroid antibodies were negative. The fiberoptic endoscopy showed a reddish mass, without evidence of haemorrhage or ulceration, confirmed as a well circumscribed, hypodense mass in the base of the tongue by computed tomography of the oropharynx and neck. Tc-99-pertechnetate scanning showed an abnormal area of uptake at the base of the tongue and no uptake in the normal thyroid location, concordant with an ectopic lingual thyroid gland. Levothyroxine in a suppressive dose was started that resulted in a reduction of the size of the mass and disappearance of dysphagia.
Assuntos
Transtornos de Deglutição/etiologia , Tireoide Lingual/complicações , Criança , Transtornos de Deglutição/diagnóstico , Diagnóstico Diferencial , Humanos , Tireoide Lingual/diagnóstico , Masculino , Testes de Função Tireóidea , Hormônios Tireóideos/sangue , Tireotropina/sangue , Tomografia Computadorizada por Raios XRESUMO
We report all year-old boy who presented with difficulty in swallowing without symptoms of hypothyroidism. The physical examination revealed a mass at the base of the tongue. The thyroid hormone profile showed a primary hypothyroidism (a serum TSH of 10.8 IU/mL with normal-low thyroxin of 6.0 fig/dL and low triiodothyronine of 57.8 ng/ dL). Antithyroid antibodies were negative. The fiberoptic endoscopy showed a reddish mass, without evidence of haemorrhage or ulceration, confirmed as a well circumscribed, hypodense mass in the base of the tongue by computed tomography of the oropharynx and neck. Tc-99-pertechnetate scanning showed an abnormal area of uptake at the base of the tongue and no uptake in the normal thyroid location, concordant with an ectopic lingual thyroid gland. Levothyroxine in a suppressive dose was started that resulted in a reduction of the size of the mass and disappearance of dysphagia.
Assuntos
Criança , Humanos , Masculino , Transtornos de Deglutição/etiologia , Tireoide Lingual/complicações , Transtornos de Deglutição/diagnóstico , Diagnóstico Diferencial , Tireoide Lingual/diagnóstico , Testes de Função Tireóidea , Hormônios Tireóideos/sangue , Tireotropina/sangue , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Lingual thyroid is a rare developmental anomaly originating from aberrant embryogenesis during descent of the gland from its site of origin, the foramen caecum, to its eutopic location. OBJECTIVE: We present the case of a 30-year-old female with a history of dysphagia and pharyngeal foreign body sensation over the past 12 months, associated with hypothyroidism. METHODS: Diagnostic and therapeutic approaches are discussed. RESULTS: Diagnosis of lingual thyroid was made and transoral thyroidectomy was performed as procedure-of-choice. Microscopic analysis revealed normal thyroid tissue with abundant colloid. The patient had an uneventful recovery and was discharged 2 days after surgery. Gamma-gram with Tc99m was scheduled for postoperative follow-up. CONCLUSIONS: Transoral lingual thyroidectomy followed by life-long hormonal therapy is the appropiate approach for patients with severe symptoms due to lingual thyroid hypertrophy associated with hypothyroidism.