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Obstructive lingual thyroid; suprahyoid intracervical surgical procedure - A case report
L Marcano Sanz1, M Endis Miranda1, J Araujo Astudillo1
1Pediatric Surgery Department. Hospital Regional Vicente Corral Moscoso. Cuenca, Azuay (Ecuador).
Summary
Lingual thyroid, a rare condition, presents challenges in management. This case highlights successful surgical removal and re-implantation for a young patient with airway obstruction, followed by long-term hormone replacement therapy.
Area of Science:
- Endocrinology
- Otolaryngology
- Surgical Oncology
Background:
- Lingual thyroid treatment is debated and requires personalized approaches.
- Management options include hormonal therapy, surgery, and radioisotope therapy.
Observation:
- An 8-year-old girl presented with a symptomatic lingual thyroid causing severe dysphagia and pharyngeal obstruction.
- Imaging confirmed the ectopic thyroid tissue at the tongue base and absence of normal thyroid gland.
- The mass was well-vascularized, non-ulcerated, and obstructed the oropharynx.
Findings:
- Initial thyroid hormone replacement was insufficient to alleviate symptoms.
- Surgical excision via cervicotomy with thyroid tissue re-implantation was successfully performed.
- The patient experienced an uneventful postoperative recovery and maintained excellent clinical status at four-year follow-up.
Implications:
- Surgical intervention with re-implantation can be a viable option for lingual thyroid causing significant obstruction.
- Long-term thyroid hormone replacement is crucial for maintaining euthyroid status post-surgery.
- Individualized treatment strategies are essential for managing ectopic thyroid tissue effectively.
