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Related Concept Videos

The Thyroid Gland01:23

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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A unique presentation of ectopic thyroid, a case report.

Erika Allen1, Masoud Alzeerah2, Stevenson Tsiao1

  • 1Texas Tech University Health Sciences Center, Amarillo 1400 S Coulter St., Amarillo, TX, 79106, United States.

International Journal of Surgery Case Reports
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PubMed
Summary

A painful ectopic thyroid, rarely presenting in the neck, was diagnosed after a fish bone ingestion led to a diagnostic dilemma. Surgical exploration revealed ectopic thyroid tissue, not a foreign body or perforation.

Keywords:
Case reportEctopic thyroid tissueExploratory laparotomyPainful presentationPeriesophageal abscess

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Area of Science:

  • Otolaryngology
  • Endocrinology
  • Pathology

Background:

  • Presents a rare case of painful ectopic thyroid tissue in an atypical neck location.
  • Highlights a diagnostic challenge due to acute symptoms and inconclusive initial imaging.
  • Involves a patient with a history of fish bone ingestion.

Purpose of the Study:

  • To report an unusual case of ectopic thyroid presenting with acute symptoms.
  • To discuss the diagnostic and therapeutic challenges in such cases.
  • To emphasize the importance of considering ectopic thyroid in differential diagnoses.

Main Methods:

  • A 61-year-old female presented with acute left throat pain and dysphagia.
  • CT scan and esophagogastroduodenoscopy (EGD) were performed.
  • Surgical exploration led to the excision of a cystic lesion.

Main Results:

  • Pathology revealed multinodular thyroid parenchyma with chronic inflammation, confirming ectopic thyroid tissue.
  • No foreign body or esophageal perforation was identified.
  • The excised lesion was cystic and not connected to the esophageal lumen.

Conclusions:

  • Ectopic thyroid tissue, though typically asymptomatic and in a typical location, can present acutely and painfully.
  • Surgical exploration served as both a diagnostic and therapeutic intervention.
  • Ectopic thyroid should be considered in the differential diagnosis for neck lesions with point tenderness, even with atypical presentations.