Conservative management for lingual thyroid ectopic

Area of Science:

• Endocrinology
• Pediatric Endocrinology
• Head and Neck Surgery

Background:

• Lingual thyroid is a rare congenital anomaly where thyroid tissue is found at the base of the tongue.
• Ectopic thyroid tissue can lead to symptoms such as dysphagia, dysphonia, and airway obstruction, particularly when enlarged.
• Early diagnosis and appropriate management are crucial for preventing complications.

Purpose of the Study:

• To report a case of lingual thyroid in an 8-year-old girl presenting with dysphagia and foreign body sensation.
• To discuss the diagnostic modalities and management options for lingual thyroid.
• To highlight the effectiveness of conservative management with Levothyroxine Sodium.

Main Methods:

• Clinical examination and patient history.
• Diagnostic imaging including thyroid scintigraphy with Tc(99m) and ultrasound.
• Laryngoscopy to confirm the presence and location of the lingual thyroid.
• Thyroid function tests to assess thyroid status.

Main Results:

• The patient presented with dysphagia and a foreign body sensation.
• Laryngoscopy confirmed a spherical mass at the base of the tongue consistent with lingual thyroid.
• Subclinical hypothyroidism was detected.
• Treatment with Levothyroxine Sodium led to TSH level stabilization and significant clinical symptom improvement over a 2-year follow-up.

Conclusions:

• Lingual thyroid, though rare, requires thorough investigation including imaging and thyroid function tests.
• Conservative management with Levothyroxine Sodium can be effective in stabilizing thyroid hormone levels and alleviating symptoms.
• Surgical intervention may not always be necessary, offering a less invasive treatment option.