Dual thyroid ectopia with submental thyroid excision using Sistrunk procedure: A case report.

Area of Science:

• Endocrinology
• Surgical Pathology
• Embryology

Background:

• Ectopic thyroid tissue, particularly dual sites, is a rare congenital anomaly.
• Congenital hypothyroidism (CH) diagnosis may be complicated by ectopic thyroid tissue, sometimes misattributed to thyroid agenesis.
• Thyroid ectopia requires careful consideration in CH patients lacking a eutopic thyroid gland.

Purpose of the Study:

• To report a case of incidentally discovered dual ectopic thyroid tissue in an adult with CH.
• To describe the surgical management of symptomatic submental ectopic thyroid tissue.
• To review the literature on pathophysiology, imaging, and surgical considerations for ectopic thyroid tissue.

Main Methods:

• A case of dual ectopic thyroid tissue (lingual and submental) was identified incidentally via computed tomography (CT) scan in an adult with CH.
• Sistrunk procedure was performed for excision of the submental ectopic thyroid due to cosmetic concerns post-bariatric surgery.
• The remaining lingual thyroid was monitored using clinical evaluation, imaging, and thyroid function tests.

Main Results:

• Dual ectopic thyroid tissue was incidentally found in an adult patient previously diagnosed with CH attributed to thyroid agenesis.
• The Sistrunk procedure successfully excised the symptomatic submental ectopic thyroid.
• Monitoring of the lingual thyroid indicated stability.

Conclusions:

• Thyroid scintigraphy may have limited utility in patients with known ectopic thyroid tissue; alternative imaging modalities are valuable.
• The Sistrunk procedure is a suitable technique for excising submental ectopic thyroid tissue, enabling histopathological examination.
• Management of ectopic thyroid tissue requires a combination of clinical assessment, imaging, and functional studies, especially in CH patients.