Ectopic thyroid tissue is rare, with a reported incidence of 1 in 300,000 (2). Ectopic thyroid parenchyma is most frequently reported in the lingual, thyroglossal and laryngotracheal sites. sellekchem Cases of ectopic thyroid tissue adjacent to the esophagus, heart, aorta and pancreas have also been described. The probability of carcinoma arising in such tissue is less than 1% (3, 4). To our knowledge, very few reports of ectopic thyroglossal thyroid cancer with a normal eutopic thyroid gland have been published to date. We share our experience of the successful management of such a rare case. Case report A 63-year-old Caucasian male presented to the Surgery Department of the University Hospital of Ioannina, Greece, with an anterior midline infiltrative mass in the neck, above the thyroid, that had appeared 4 months previously.
His medical history was unremarkable. Clinical examination revealed no pyrexia, heart rate 80 bpm and normal blood pressure. Physical examination revealed a midline neck mass anterior to the thyroid cartilage. The thyroid gland was normal and no cervical lymphadenopathy was noted. Following fine needle aspiration (FNA), papillary thyroid carcinoma was diagnosed (Figure 1). A CT scan showed a solid cystic mass located anterior to the thyroid cartilage with a normal thyroid gland. Figure 1 Midline mass in the neck after FNA examination. Surgery was performed under general anesthesia 2 days later (Figure 2), with excision of the mass, total thyroidectomy and neck dissection (Figures 3, ,4).4).
Pathological examination revealed a normal thyroid gland, papillary thyroid carcinoma in the cervical mass resected radically and 16 lymph nodes without metastatic involvement. Figure 2 Patient in the operating room. Figure 3 Intraoperative image. Figure 4 Intraoperative image (total thyroidectomy, excision of the mass and neck dissection). The postoperative period was uneventful and the patient was discharged from the hospital 3 days later with the recommendation to undergo radioactive iodine therapy. Six months later, the patient remains asymptomatic (Figure 5). Figure 5 Patient 6 months after surgery. Discussion The most common sites for an ectopic thyroid gland are lingual, thyroglossal and laryngotracheal. Other, rarer sites include the esophagus, heart, aorta, duodenum and mediastinum (5).
The incidence of ectopic thyroid tissue is reported as 1 in 300,000 in the normal population, mainly affecting females (4:1) (6). The presence of a midline neck mass above the thyroid should raise the suspicion of ectopic thyroid tissue in a thyroglossal duct remnant. Cilengitide The probability of carcinoma arising in ectopic thyroid tissue in thyroglossal duct remnant is reported in the literature as less than 1%, involving in almost in all cases papillary carcinomas, as with our patient (7).