Lingual thyroid gland: it's time for awareness

Area of Science:

• Endocrinology
• Otolaryngology
• Medical Case Reports

Background:

• Lingual thyroid (LT) is the most common form of ectopic thyroid tissue, though its occurrence is rare.
• Patients may present with symptoms like dysphonia and dysphagia due to tongue base masses.

Purpose of the Study:

• To present a case of lingual thyroid diagnosed and managed in a 41-year-old female.
• To highlight the efficacy of thyroid hormone replacement therapy (THRT) in managing lingual thyroid symptoms and size.

Main Methods:

• Diagnosis involved fiber optic flexible indirect laryngoscopy (FIL), neck ultrasound, and thyroid scintigraphy.
• Treatment included initiating levothyroxine therapy for subclinical hypothyroidism.

Main Results:

• FIL revealed a mass at the base of the tongue, suspicious for ectopic thyroid tissue.
• Levothyroxine therapy led to symptom resolution and a reduction in the mass size.
• The patient's subclinical hypothyroidism was favorably managed.

Conclusions:

• Lingual thyroid diagnosis requires a combination of clinical evaluation and imaging.
• Thyroid hormone replacement therapy can be an effective non-surgical management option for lingual thyroid, potentially avoiding profound hypothyroidism.
• Histopathology is crucial for differentiating benign from malignant lingual thyroid, as they are clinically and radiographically indistinguishable.