Lingual thyroid carcinoma with nodal metastasis

Area of Science:

• Oncology
• Head and Neck Surgery
• Endocrinology

Background:

• Lingual thyroid carcinoma is an extremely rare malignancy, with fewer than 40 cases previously reported in the literature.
• This study focuses on the diagnosis and management of a unique case of lingual thyroid carcinoma presenting with cervical metastasis.

Observation:

• A young female presented with a cervical neck mass, diagnosed as metastatic papillary thyroid carcinoma.
• Imaging revealed the primary tumor located at the base of the tongue, with the absence of an orthotopic thyroid gland and bilateral cervical lymphadenopathy.

Findings:

• Surgical excision of the tongue base lesion and bilateral selective neck dissections confirmed lingual thyroid carcinoma with extensive cervical nodal metastasis.
• Papillary thyroid carcinoma was the predominant histopathology, a finding not previously established in the literature for lingual thyroid carcinoma.

Implications:

• Surgical management requires careful consideration of the primary tumor size and extent of lymph node involvement.
• The recommended treatment strategy includes complete surgical excision of all thyroid tissue followed by radioactive iodine ablation for optimal outcomes.