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Hyperthyroidism I: Introduction

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Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

Hypothyroidism II: Pathophysiology

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Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...

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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

Graves Disease II: Pathophysiology

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Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...

Goiter

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Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...

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Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...

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Thyroid hemiagenesis, ectopic submandibular thyroid tissue, and apparent persistent subclinical thyrotoxicosis.

Fusun Aydogan¹, Akin Aydogan, Seckin Akkucuk

¹Department of Nuclear Medicine, Mustafa Kemal University, Hatay, Turkey.

Thyroid : Official Journal of the American Thyroid Association

|November 20, 2012

Summary

This case report details a rare instance of thyroid hemiagenesis with ectopic thyroid tissue in the submandibular region. The patient presented with symptoms suggestive of mild thyrotoxicosis due to the ectopic thyroid tissue.

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Area of Science:

Endocrinology
Embryology
Radiology

Background:

Ectopic thyroid tissue (ETT) is a rare congenital anomaly where thyroid tissue is found outside its normal anatomical location.
Thyroid hemiagenesis (HA) is an even rarer condition involving the incomplete development of one thyroid lobe during embryogenesis.

Observation:

A 38-year-old female presented with palpitations and sweating, exhibiting left thyroid hemiagenesis and a right lobe with heterogeneous echogenicity.
Imaging confirmed absence of the left thyroid lobe and revealed ectopic thyroid tissue in the right submandibular region.
Thyroid scintigraphy demonstrated radiotracer uptake in the right lobe and submandibular ETT, with no uptake in the left thyroid bed.

Findings:

The patient exhibited persistently suppressed serum TSH levels (0.11 mIU/L), with normal free T3 and T4 levels.
Ultrasonography of the right thyroid lobe indicated heterogeneity and hypoechogenicity, suggestive of thyroiditis.
This represents a potential first report of concurrent thyroid hemiagenesis and submandibular ectopic thyroid tissue.

Implications:

The findings suggest the patient likely experienced mild, intermittent thyrotoxicosis secondary to the submandibular ectopic thyroid tissue.
This case highlights the importance of comprehensive imaging and biochemical evaluation in diagnosing rare thyroid developmental abnormalities.
Understanding such rare presentations is crucial for accurate diagnosis and management of thyroid dysfunction.