[Lingual goiter with special regard to diagnosis and therapy]

Starting with a case report, epidemiology, diagnosis, therapy and prognosis of lingual thyroid are discussed with special reference to the decisive value of scintigraphy. The usual 99mTc-scan often fails in detection of ectopic thyroid tissue because of tracer accumulation in salivary glands and its excretion into the oral cavity. Another disadvantage is the relatively high tissue absorption of 99mTc-photons. According to the low sensitivity and specificity of usual 99mTc-scintigraphy, all patients with suspected ectopic thyroid tissue and especially in case of suspected tumor in the retrolingual region should be examined by radio-iodine-imaging (123I, 123I). The decision between conservative and surgical therapy depends on subjective complaints, regional iodine uptake and growth behaviour of the lingual thyroid, and especially on cytological findings of fine needle biopsy, which is not dangerous in expert hands.