Case Report: Partial resection of lingual ectopic thyroid using an electrohook under laryngoscopic guidance

Lingual thyroid is a rare ectopic thyroid disorder, with an incidence of 1 in 100,000-300,000. Surgical treatment options include transoral robotic surgery, transoral laser microsurgery, and coblation; however, these require expensive equipment, which may limit accessibility. We report a case that was successfully treated using an electrohook, a universally available and cost-effective alternative.

A 56-year-old woman presented with a 10-year history of foreign body sensation and dysphagia, which had recently worsened and was significantly affecting her quality of life, prompting her to seek medical attention.

Based on electronic laryngoscopy revealing a mass at the tongue base, elevated thyroid-stimulating hormone (TSH) levels (40 μIU/mL), a reduced cervical thyroid on ultrasonography, and contrast-enhanced CT demonstrating a characteristic thyroid-like enhancement pattern, a diagnosis of lingual ectopic thyroid with hypothyroidism was made. Postoperative pathology confirmed well-differentiated ectopic thyroid tissue.

The patient received preoperative levothyroxine (25 μg/day). Under general anesthesia, with laryngoscope support, a partial resection was performed using an electrohook, which enabled simultaneous cutting and hemostasis. The procedure lasted 45 min and was associated with minimal blood loss (20 mL). Postoperatively, she received antibiotics and continued thyroid hormone replacement therapy. Her symptoms resolved completely, and recovery was uneventful. At the 3-month follow-up, she remained asymptomatic, with normalized thyroid function (TSH 5.2 μIU/mL) and an improved quality of life.

Electrohook resection under laryngoscopic guidance is a simple, cost-effective, and safe treatment for symptomatic lingual ectopic thyroid, particularly suitable for primary hospitals, and may improve treatment accessibility for this rare condition.