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[A rare case of ectopic, normally functioning thyroid tissue presenting as a left submandibular mass]
Hiroaki Kanaya1, Yoshiyuki Tanigaito, Noboru Shyono
1Department of Otorhinolaryngology and Bronchoesophagology, Dokkyo University School of Medicine, Tochigi.
Nihon Jibiinkoka Gakkai Kaiho
|October 13, 2005
Summary
A painless submandibular swelling was diagnosed as ectopic thyroid tissue. This ectopic tissue compensated for post-thyroidectomy hypothyroidism by secreting thyroid hormone.
Area of Science:
- Endocrinology
- Surgical Pathology
- Head and Neck Surgery
Background:
- A 53-year-old female presented with a gradually enlarging, painless left submandibular mass.
- History of subtotal thyroidectomy 30 years prior with subsequent normal thyroid function and no current hypothyroid symptoms.
Observation:
- Clinical diagnosis suggested a benign submandibular gland tumor based on enhanced CT, MRI, and technetium scintigraphy.
- Surgical excision revealed a well-delineated, encapsulated, reddish-brown mass.
- Histological examination confirmed ectopic thyroid tissue with partial adenomatous goiter and vacuolated colloid, indicative of compensatory hyperplasia.
Findings:
- The resected mass was identified as functional ectopic thyroid tissue.
- This ectopic thyroid tissue demonstrated compensatory hyperplasia, suggesting it was the sole source of thyroid hormone production.
Implications:
- Ectopic thyroid tissue can present as a submandibular mass.
- It should be considered in the differential diagnosis of neck swellings, particularly in patients with a history of thyroidectomy.
- Ectopic thyroid tissue may represent the only functioning thyroid tissue, necessitating its preservation if feasible.