Document Detail


Lingual thyroid in children: a rare clinical entity.
MedLine Citation:
PMID:  18418276     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES/HYPOTHESIS: To study the presentation, management, and long-term outcome of children presenting with lingual thyroid. STUDY DESIGN: Institutional review board approved, retrospective study (1993-2004). METHODS: The study was conducted at a tertiary care pediatric medical center. The main outcomes measured were initial presentation, radiographic findings, endocrine evaluation, surgical outcome, pathologic features, complications, need for hormonal replacement. RESULTS: Four patients presented to the Department of Otolaryngology and Communications Enhancement, Children's Hospital Boston with lingual thyroid between 1993 and 2004. All patients were female, with an age range of 2 to 12 years (x = 6). All patients presented with a mass (1.4-3.5 cm) and most with respiratory or feeding difficulty. Magnetic resonance imaging was obtained in three patients and revealed a mass consistent with lingual thyroid. Thyroid scan confirmed the lingual thyroid as the only functioning thyroid in all four patients. None of the patients responded to hormonal replacement, and all underwent surgical excision of the mass. Surgical approach included midline glossotomy (n = 2) and CO2 laser excision (n = 2). Pathologic evaluation confirmed lingual thyroid in all four patients. No evidence of malignancy was seen in any patient. All four patients require lifelong hormonal replacement. CONCLUSIONS: Lingual thyroid is a rare condition, with an incidence of 1:100,000. This infrequent congenital anomaly is often asymptomatic until a pathologic stress such as systemic disease or physiologic stress such as puberty causes enlargement of the ectopic tissue, leading to dysphagia, dysphonia, and dyspnea. The work-up should include routine blood work including thyroid function tests thyrotropin, thyroxine, and thyroid hormone binding ratio; iodine thyroid scintigraphy; and computerized tomography or magnetic resonance imaging. The majority of patients require surgical excision of the symptomatic mass and, in case of absence of orthotopic thyroid tissue, long-term thyroid hormone replacement.
Authors:
Reza Rahbar; Michelle J Yoon; Leonard P Connolly; Caroline D Robson; Sara O Vargas; Trevor J McGill; Gerald B Healy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  118     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-02     Completed Date:  2008-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1174-9     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology and Communication Enhancement, Children's Hospital Boston, Boston, Massachusetts 02115, USA. reza.rahbar@childrens.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Airway Obstruction / etiology,  pathology,  surgery
Child
Child, Preschool
Female
Glossectomy
Humans
Image Enhancement
Iodine Radioisotopes / diagnostic use
Laser Therapy
Lingual Thyroid / diagnosis*,  pathology,  surgery
Magnetic Resonance Imaging
Radionuclide Imaging
Thyroid Function Tests
Tongue / pathology
Chemical
Reg. No./Substance:
0/Iodine Radioisotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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