Abstract:Lingual thyroid and thyroid hemiagenesis are rare thyroid developmental abnormalities. These conditions can be present with other thyroid diseases, whether functional ones involving abnormal thyroid hormone levels, or structural ones such as presence of thyroid nodules, however the association with thyroid cancer and lingual thyroid or thyroid hemiagenesis is rare. In addition to that, when thyroid hemiagenesis is present, it is usually in the left lobe. We describe here a pregnant patient who presented with m… Show more
“…In the ninth month of evaluation, thyroid USG evaluation revealed fibrotic tissue in the right thyroid bed and bilateral lymphadenopathy, although there was no recurrence complains. This is in line with a study by Azmat et al, which stated a key finding of thyroid cancer accompanying TH suspicion is a metastatic cervical node.6 However, the association between TH and thyroid cancer is uncommon [6] . Moreover, the possibility of an ectopic thyroid tissue is also need to consider.…”
Section: Discussionsupporting
confidence: 91%
“…Based on a literature review, thyroid malignancies were reported in only 3% of TH cases [5] . Similarly, ectopic thyroid tissues were also reported in 3% of cases [6] . It is more common in female patients and the majority includes left lobe hemiagenesis comprising more than 80% of all diagnosed cases [2] , [5] , [7] .…”
Introduction and importance
Thyroid hemiagenesis (TH) is a rare congenital anomaly where one lobe fails to develop, especially more frequently occurs on the left lobe. The exact mechanisms for thyroid morphogenesis remain unclear. In this paper, we report a rare case of right lobe TH associated with Hurthle cell carcinoma.
Case presentation
A 59 years old woman was admitted with a neck lump increasing in size in the last 20 years. There were no symptoms of hyperthyroidism and hypothyroidism. There was a palpable, painless 5 cm mass in the middle of the neck. Initial thyroid ultrasonography (USG) revealed an enlarged left lobe, with hypoechoic lesion with cystic component and calcification (TIRADS 4). However, the right lobe was non-visualized. Fine needle aspiration biopsy result tendency was a malignancy. Hence, isthmolobectomy was conducted. Pathology result was Hurthle cell carcinoma. On the ninth month, USG revealed fibrotic tissue in the right thyroid bed and bilateral lymphadenopathy. Due to discrepancy, the patient was planned for a neck exploration surgery and a right lobe incision. Intraoperatively, the right thyroid was absent. Intraoperative USG also confirmed no right thyroid lobe.
Discussion
Thyroid hemiagenesis can be visualized by using USG due to its practicality and cost effectiveness reasons. Follow up evaluations consisted of systematic monitoring of thyroid morphology and hormonal functions should follow the diagnosis of TH. Neck exploration surgery might need to be performed to clarify any discrepancy and confirm the diagnosis.
Conclusion
TH can be recognized through supporting examination; however, discrepancy may occur.
“…In the ninth month of evaluation, thyroid USG evaluation revealed fibrotic tissue in the right thyroid bed and bilateral lymphadenopathy, although there was no recurrence complains. This is in line with a study by Azmat et al, which stated a key finding of thyroid cancer accompanying TH suspicion is a metastatic cervical node.6 However, the association between TH and thyroid cancer is uncommon [6] . Moreover, the possibility of an ectopic thyroid tissue is also need to consider.…”
Section: Discussionsupporting
confidence: 91%
“…Based on a literature review, thyroid malignancies were reported in only 3% of TH cases [5] . Similarly, ectopic thyroid tissues were also reported in 3% of cases [6] . It is more common in female patients and the majority includes left lobe hemiagenesis comprising more than 80% of all diagnosed cases [2] , [5] , [7] .…”
Introduction and importance
Thyroid hemiagenesis (TH) is a rare congenital anomaly where one lobe fails to develop, especially more frequently occurs on the left lobe. The exact mechanisms for thyroid morphogenesis remain unclear. In this paper, we report a rare case of right lobe TH associated with Hurthle cell carcinoma.
Case presentation
A 59 years old woman was admitted with a neck lump increasing in size in the last 20 years. There were no symptoms of hyperthyroidism and hypothyroidism. There was a palpable, painless 5 cm mass in the middle of the neck. Initial thyroid ultrasonography (USG) revealed an enlarged left lobe, with hypoechoic lesion with cystic component and calcification (TIRADS 4). However, the right lobe was non-visualized. Fine needle aspiration biopsy result tendency was a malignancy. Hence, isthmolobectomy was conducted. Pathology result was Hurthle cell carcinoma. On the ninth month, USG revealed fibrotic tissue in the right thyroid bed and bilateral lymphadenopathy. Due to discrepancy, the patient was planned for a neck exploration surgery and a right lobe incision. Intraoperatively, the right thyroid was absent. Intraoperative USG also confirmed no right thyroid lobe.
Discussion
Thyroid hemiagenesis can be visualized by using USG due to its practicality and cost effectiveness reasons. Follow up evaluations consisted of systematic monitoring of thyroid morphology and hormonal functions should follow the diagnosis of TH. Neck exploration surgery might need to be performed to clarify any discrepancy and confirm the diagnosis.
Conclusion
TH can be recognized through supporting examination; however, discrepancy may occur.
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