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      A rare case of lingual thyroid with hyperthyroidism: A case report and review of the literature

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          Abstract

          Lingual thyroid is a rare embryological anomaly resulting from failure of normal thyroid tissue to descend from the foramen cecum at base of tongue to its orthotopic location in front of the lower neck. It is a rare anomaly with a reported incidence of 1 in 3000 of the thyroid disorders. Lingual thyroid is often asymptomatic but may cause local symptoms such as dysphagia, dysphonia with stomatolalia, upper airway obstruction, and often with hypothyroidism. Hyperthyroidism is extremely rare finding and till now there are very few case reports published. We present here a case of lingual thyroid with hyperthyroidism, which was treated successfully with radioiodine.

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          Most cited references9

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          Lingual thyroid and hyperthyroidism: a new case and review of the literature.

          Lingual thyroid is the result of a defective migration of the thyroid anlage occurring between the 3rd and 7th week of gestation. Whereas mutations in the transcription factor-2 (TTF-2) and PAX8 and in the TSH receptor genes (TSH-R) have been reported in a minority of patients with thyroid dysgenesis, the etiopathogeny of the majority of cases, and in particular of thyroid ectopy, remains unclear. The majority of patients with thyroid ectopy are asymptomatic, but obstructive symptoms as well as hypothyroidism have been observed. Hyperthyroidism is an exceptionally rare finding. To our knowledge, only 2 cases have been reported in the literature to date. Herein, we describe an unusual case of thyrotoxicosis related to a nodular lesion in a lingual thyroid. Treatment consisted in restoration of a euthyroid state with thionamide followed by surgical removal of the ectopic gland. The underlying molecular cause of the ectopic lingual thyroid and the toxic adenoma in this case could not be identified. We speculate that abnormally early differentiation of the thyroid gland could interfere with the migration process, a hypothesis yet to be confirmed.
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            Ectopic thyroid gland in the submandibular region simulating a thyroglossal duct cyst: a case report.

            The inadvertent removal of ectopic thyroid gland (ETG) that was mistaken for a thyroglossal duct cyst (TDC) leading to important hypothyroidism has been reported in the literature. The authors report the case of a 4-year-old boy with an ETG mimicking a normal TDC, in whom the preliminary diagnosis was a TDC. The diagnosis, the anatomic location of the ETG, and the management of this congenital anomaly are discussed.
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              Ectopic goiter masquerading as submandibular gland swelling: a case report and review of the literature.

              Ectopic thyroid glands generally occur in the midline as a result of abnormal median migration, and their presence lateral to the midline is rare. A 12-year-old boy had a swelling in the left submandibular region that imaging techniques showed to be an ectopic thyroid gland, although no thyroid tissue was seen in the normal location. Only eight cases of lateral aberrant thyroid tissue have been reported. The importance of being aware of the possibility of ectopic thyroid tissue as a submandibular region swelling has an important bearing on disease management. A pertinent review of the literature and its management is included.
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                Author and article information

                Journal
                Indian J Endocrinol Metab
                Indian J Endocrinol Metab
                IJEM
                Indian Journal of Endocrinology and Metabolism
                Medknow Publications & Media Pvt Ltd (India )
                2230-8210
                2230-9500
                May-Jun 2012
                : 16
                : 3
                : 441-443
                Affiliations
                [1] Department of Nuclear Medicine, Army Hospital Research and Referral, Dhaula kuan, New Delhi, India
                Author notes
                Corresponding Author: Dr. Mudalsha Ravina, K. S. Nursing Home, Near Post Office, Badshapur, Gurgaon, Haryana – 122 101, India. E-mail: mudalsharavina@ 123456gmail.com
                Article
                IJEM-16-441
                10.4103/2230-8210.95708
                3354857
                22629516
                ec4624c4-d871-4914-a736-209a9d3a92d6
                Copyright: © Indian Journal of Endocrinology and Metabolism

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Case-Based Review of Literature

                Endocrinology & Diabetes
                hyperthyroidism,lingual thyroid,radioiodine
                Endocrinology & Diabetes
                hyperthyroidism, lingual thyroid, radioiodine

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