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

Li Xian Lim1, Grace Tim-Yan Kwok1, Eva Wong2

  • 1Head and Neck Unit, Westmead Hospital, 166-174 Hawkesbury Road, Westmead, NSW 2145, Australia.

International Journal of Surgery Case Reports
|May 6, 2021
PubMed
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Dual ectopic thyroid tissue is rare, often overlooked in congenital hypothyroidism. This case highlights surgical excision of submental thyroid and monitoring of lingual thyroid for effective management.

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.
Keywords:
Case reportEctopic thyroidLingual thyroidSistrunk procedureSubmental thyroid

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  • 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.