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Synthesis and Regulation of Thyroid Hormones01:20

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
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A Challenging Case of Hyperfunctioning Submandibular Ectopic Thyroid Successfully Treated With 131 I.

Giusi Pisano1, Serena Sassano1, Esther Diana Rossi2

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Summary

Ectopic thyroid tissue, a rare developmental anomaly, can cause recurrent hyperthyroidism. This case highlights successful treatment of submandibular ectopic thyroid tissue with radioactive iodine therapy.

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Area of Science:

  • Endocrinology
  • Surgical Pathology
  • Nuclear Medicine

Background:

  • Ectopic thyroid tissue arises from developmental errors during embryogenesis.
  • Thyroid pathologies, including tumors, can affect ectopic thyroid tissue.
  • Recurrent hyperthyroidism poses a diagnostic challenge, especially after thyroid surgery.

Observation:

  • A patient with a history of thyroidectomy presented with relapsed hyperthyroidism.
  • A technetium-99m scan showed focal uptake in the submandibular region.
  • Differential diagnosis included salivary gland tumor versus ectopic thyroid tissue.

Findings:

  • Histopathology confirmed hyperfunctioning submandibular ectopic thyroid tissue.
  • The patient's hyperthyroidism was successfully treated with radioactive iodine (131I).

Implications:

  • This case underscores the importance of considering ectopic thyroid tissue in cases of recurrent hyperthyroidism.
  • Accurate diagnosis is crucial for appropriate management, distinguishing it from other neck masses.
  • Radioactive iodine therapy is an effective treatment for hyperfunctioning ectopic thyroid tissue.