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Lingual thyroid presenting after previous thyroglossal cyst excision

D J Alderson1, F J Lannigan

  • 1Department of Otolaryngology, General Infirmary at Leeds.

The Journal of Laryngology and Otology
|April 1, 1994
PubMed
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Lingual thyroid, a rare condition from thyroid gland maldescent, presents as a tongue mass. Treatment ranges from thyroxine therapy to surgical excision, with potential for hypothyroidism.

Area of Science:

  • Endocrinology
  • Developmental Biology
  • Head and Neck Surgery

Background:

  • Lingual thyroid is a rare congenital anomaly resulting from the failure of the thyroid gland to descend properly during embryonic development.
  • It represents a significant cause of oropharyngeal mass, specifically affecting the posterior third of the tongue.

Observation:

  • This condition may occur concurrently with other developmental abnormalities, such as thyroglossal cysts.
  • Diagnosis is typically confirmed through radioisotope scanning, which visualizes ectopic thyroid tissue.
  • Symptomatic lingual thyroid necessitates intervention, commencing with conservative thyroxine hormone replacement therapy.

Findings:

  • Severe or refractory cases warrant surgical intervention, often requiring a lateral pharyngotomy approach for complete excision.

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  • Post-surgical hypothyroidism is a frequent complication, necessitating lifelong thyroid hormone management.
  • In select instances, transplantation of excised thyroid tissue can mitigate or prevent postoperative hypothyroidism.

    • Implications:

    • Accurate diagnosis and appropriate management of lingual thyroid are crucial for patient outcomes.
    • Understanding the embryological basis aids in recognizing associated anomalies.
    • Surgical techniques and tissue transplantation offer strategies to improve functional preservation after treatment.