Ectopic Intrapulmonary Thyroid Tissue Mimicking Metastatic Tissue

Ryu, Han Suk; Chung, Yun Jae; Chong, Semin; Lee, Ji In

doi:10.1089/thy.2012.0014

Cited by 11 publications

(9 citation statements)

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“…It is also highlighted in this case that the patient had bilateral ovarian serous cystadenoma synchronously. Ryu HS [9] had described a case of ectopic intrapulmonary thyroid mimicking multiple pulmonary metastases from an endometrioid adenocarcinoma of the uterus. Coincidentally, the intrapulmonary nodules in our case were also mistakenly considered as pelvic tumor metastases at first.…”

Section: Discussionmentioning

confidence: 99%

Ectopic thyroid microfollicular adenoma in the lung

Zhang¹,

Zhang²,

Hou³

et al. 2019

Medicine

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Introduction:Ectopic thyroid occurs due to aberrant development of the thyroid gland during its migration to the pretracheal region. Intrapulmonary ectopic thyroid is extremely rare and its benign transformation (microfollicular adenoma) has never been reported. This paper reports a case of ectopic thyroid microfollicular adenoma in the lung mimicking metastatic pelvic tumors.Patient concerns:A 76-year old female presented to our hospital because of transient unconsciousness. Pelvic ultrasound (US) and chest computed tomography (CT) showed pelvic tumors and pulmonary nodules.Diagnosis and interventions:The patient underwent pelvic tumors resection and CT-guided fine-needle aspiration cytology (FNAC) at the largest pulmonary nodule. Pathological description revealed bilateral ovarian serous cystadenoma and endometrioma in pelvic, and ectopic thyroid microfollicular adenoma in lung. In view of the patient's age and physical conditions, it is unanimously decided by the physicians and the family members of the patient to closely follow up this benign pulmonary lesion.Outcomes:During the 12-month follow-up, no pelvic tumor recurrence or metastasis was found. CT review of pulmonary nodules showed no remarkable changes. The patient was asymptomatic and euthyroid after being discharged from the hospital.Conclusion:Ectopic thyroid microfollicular adenoma in the lung is extremely rare and can be easily mistaken for pulmonary metastases from other sites. The case reported in this paper highlights that ectopic intrapulmonary thyroid tumor should not be overlooked.

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Section: Discussionmentioning

confidence: 99%

Ectopic thyroid microfollicular adenoma in the lung

Zhang¹,

Zhang²,

Hou³

et al. 2019

Medicine

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“…Intrapulmonary benign thyroid tissue is very rare, with only seven cases reported so far [ 3 - 9 ]. Most of these cases were interpreted as ectopic thyroid, because they were found either during the work-up of a solitary pulmonary nodule [ 4 , 7 ] or at autopsy without evidence of a primary thyroid gland tumor [ 6 , 9 ]. And the nodules were always single [ 3 - 6 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a recent review, Sood A et al reported 27 cases of dual ectopic thyroid gland [ 10 ]. Only one case of simultaneously bilateral intropulmonary ectopic thyroid has been reported before [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…So if this case was metastizing thyroid carcinoma, the question arose as to how the distant metastasis in the lung and the benign pathological characteristic of pulmonary metastatic lesions might be explained. In fact, according to the literature, there were several cases in which it was reported that occult thyroid carcinoma could metastasize to distant organs, including the lung [ 7 ]. Research was also conducted about the morphology of metastatic lesion of thyroid tumors.…”

Section: Discussionmentioning

confidence: 99%

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Multiple thyroid nodules in the lung: metastasis or ectopia?

et al. 2015

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BackgroundIntrapulmonary thyroid tissue with no malignant history of the thyroid gland is extremely rare. Usually, it is interpreted as ectopic thyroid tissue. Here we describe a case of bilateral pulmonary thyroid nodules with a history of multinodular thyroid goiter.HistoryA 37-year-old female had recurrent multinodular thyroid goiter and showed bilateral pulmonary nodules on CT scan. Video-assisted thoracic surgery (VATS) was performed for the largest nodule biopsy. Pathological and molecular examinations were done after biopsy, and both were shown the characters of benign thyroid tissues. To eliminate the possibility of thyroid carcinoma metastases, total thyroidectomy with modified radical neck dissection was performed, and there were no malignant pathological findings. After surgery, this patient accepted adjuvant radiometabolic treatment for ablation of the remaining intrapulmonary nodules. Her thyroglobulin level decreased to an undetectable level, and she has currently survived for 24 months after surgery.Clinical significanceIn this case, pulmonary ectopic thyroid and metastasizing thyroid carcinoma should both be considered, but the metastatic pattern and benign pathological characters were inconsistent with any of the corresponding diagnosis. Ultimately, this patient accepted postoperative treatment of thyroid carcinoma metastasis.ConclusionsThis is a rare thyroid disease with malignant behavior but no pathological evidence. Careful diagnosis and postoprative follow-up should be carried out whenever such nodules are encountered in clinical practice.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1255194331453728.

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“…Usually, aberrant ectopic thyroid tissue occurs along the midline and rarely in the gall bladder, lung, adrenal gland, heart or liver [ 2 – 6 ]. To our knowledge, most ectopic thyroid tissue in the lung is in a single lobe or homolateral lobes, and only 4 cases of ectopic intrapulmonary thyroid tissue in the bilateral lung lobes have been reported in the literature [ 7 – 10 ]. However, it is extremely difficult to diagnose multiple solid pulmonary nodules using only the patient’s clinical information and radiological findings.…”

Section: Introductionmentioning

confidence: 99%

Rare ectopic thyroid tissue as multiple bilateral pulmonary nodules: a case report and literature review

Tan

Kuang

et al. 2022

J Cardiothorac Surg

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Background The prevalence of ectopic thyroid tissue is 1 in every 100,000 to 300,000 persons in the general population, and ectopic thyroid tissue in the bilateral lung lobes is even rarer. Due to its rarity, there is no definitive or standard guidance on the diagnosis and treatment of ectopic thyroid tissue presenting as multiple bilateral pulmonary nodules. Case presentation A 56-year-old woman presented with multiple bilateral pulmonary nodules, and the patient had a history of hyperthyroidism but had no symptoms of ectopic thyroid tissue. Computed tomography (CT) demonstrated multiple solid nodules in both lungs, and the largest nodule (sized 15 × 14 mm) was located in segment 5 of the upper left lung. The initial diagnosis based on imaging was metastatic malignancies. Positron emission tomography-computed tomography (PET-CT) showed multiple bilateral intrapulmonary nodules that had slightly increased metabolism (SUVmax 1.7). The largest pulmonary nodule and another nodule in the left lung were resected by video-assisted thoracoscopy surgery (VATS). The pathological and immunohistochemical (IHC) examinations confirmed a diagnosis of ectopic thyroid tissue. No postoperative adjuvant therapy was given, and the patient was discharged 3 days after the operation and had regular follow-up examinations. Conclusion The diagnosis of ectopic thyroid tissue in the bilateral lung lobes is extremely difficult and should be considered carefully. PET-CT and surgical resection of intrapulmonary nodules are alternatives for clinicians in diagnosing ectopic thyroid tissue. Regular postoperative follow-up is needed.

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Ectopic Intrapulmonary Thyroid Tissue Mimicking Metastatic Tissue

Abstract: Ectopic intrapulmonary thyroid is extremely rare but can be confused with pulmonary metastases from other sites. We are unaware of similar cases in the literature.

Cited by 11 publications

References 10 publications

Ectopic thyroid microfollicular adenoma in the lung

Ectopic thyroid microfollicular adenoma in the lung

Multiple thyroid nodules in the lung: metastasis or ectopia?

Rare ectopic thyroid tissue as multiple bilateral pulmonary nodules: a case report and literature review

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