Graves' disease and recurrence in ectopic thyroid tissue after total thyroidectomy.

Area of Science:

• Endocrinology
• Nuclear Medicine

Background:

• Graves' disease, an autoimmune disorder, often necessitates total thyroidectomy.
• Ectopic thyroid tissue can rarely retain functional capacity post-surgery.

Observation:

• A 46-year-old woman developed a midline neck mass two years post-thyroidectomy for Graves' disease.
• Despite levothyroxine withdrawal, she exhibited subclinical hyperthyroidism with elevated thyroid stimulating hormone receptor antibodies.
• Ultrasonography and scintigraphy identified an infrahyoid nodule with increased radioactive iodine uptake.

Findings:

• Methimazole treatment normalized thyroid function and reduced the neck mass.
• Radioactive iodine therapy led to mass regression and successful management with levothyroxine replacement.
• This case highlights recurrent Graves' disease in ectopic thyroid tissue.

Implications:

• Consider ectopic thyroid recurrence in thyrotoxicosis post-total thyroidectomy.
• Early diagnosis and appropriate management are crucial for patient outcomes.
• This underscores the importance of considering rare presentations in clinical practice.