Ectopic thyroid in an adrenal mass: a case report

Hagiuda, Jun; Kuroda, Isao; Tsukamoto, Takuji; Ueno, Munehisa; Yokota, Chizuko; Hirose, Takanori; Deguchi, Nobuhiro

doi:10.1186/1471-2490-6-18

Cited by 40 publications

(32 citation statements)

References 8 publications

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“…The patients were euthyroid and ectopic gland was diagnosed on histological examination after adrenalectomy. Enlarged adrenals, sometimes with a cystic compartment, were detected either incidentally or after investigation for secondary hypertension (10,(50)(51)(52)(53).…”

Section: Other Sitesmentioning

confidence: 99%

Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity

Noussios

Anagnostis²,

Goulis³

et al. 2011

European Journal of Endocrinology

303

429

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Ectopic thyroid tissue is a rare entity resulting from developmental defects at early stages of thyroid gland embryogenesis, during its passage from the floor of the primitive foregut to its final pre-tracheal position. It is frequently found around the course of the thyroglossal duct or laterally in the neck, as well as in distant places such as the mediastinum and the subdiaphragmatic organs. Although most cases are asymptomatic, symptoms related to tumor size and its relationship with surrounding tissues may also appear. Any disease affecting the thyroid gland may also involve the ectopic thyroid, including malignancy. The clinician must distinguish between ectopic thyroid and metastatic deposits emerging from an orthotopic gland, as well as other benign or malignant masses. Thyroid scintigraphy plays the most important role in diagnosing ectopy, but ultrasonography contributes as well. In cases of symptomatic disease, surgery is the treatment of choice, followed by radioiodine ablation and levothyroxine suppression therapy in more refractory cases. This review provides current understanding about the wide clinical spectrum of this rare condition, also referring to optimal diagnostic approach, differential diagnosis, and management strategies.

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Section: Other Sitesmentioning

confidence: 99%

Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity

Noussios

Anagnostis²,

Goulis³

et al. 2011

European Journal of Endocrinology

303

429

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“…Women are much more frequently affected than men (8:1), and most cases clinically presented in the fifth decade (mean age 54, range 38-67) as a cystic adrenal mass incidentally discovered on abdominal US or in CT images. The first six cases of ETTAG were reported in the Japanese population (23)(24)(25)(26)(27); however, a seventh case in an African American woman has been more recently published (28), and our two cases have been found in women from Colombia and Spain, respectively.…”

Section: Discussionmentioning

confidence: 62%

“…Infradiaphragmatic ectopic thyroid has been reported in the submucosa of the duodenum (13), small intestinal mesentery (14), porta hepatis (12), gallbladder (15,16), pancreas (17), periesplenic area (18), ovary (19,20), fallopian tube (20), inguinal region (21), and vagina (22). To our knowledge, only seven cases of ETTAG have been reported in the literature (23)(24)(25)(26)(27)(28) (Table 1). Women are much more frequently affected than men (8:1), and most cases clinically presented in the fifth decade (mean age 54, range 38-67) as a cystic adrenal mass incidentally discovered on abdominal US or in CT images.…”

Section: Discussionmentioning

confidence: 99%

“…Previous explanations for why thyroid tissue can be found in the adrenal gland include metastasis, teratoma, metaplasia, heterotopia (choristoma), and overdescent of the hypoglossal duct remnant (23)(24)(25)(26)28). One case of ETTAG with concomitant incidental (nonrelated) micropapillary thyroid carcinoma was reported (28), and two cases of ETTAG were incidental findings during preoperative abdominal CT for gastric cancer (26,27); metastatic thyroid cancer, however, was excluded in all published cases (23)(24)(25)(26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

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Ectopic Thyroid Tissue in the Adrenal Gland: A Report of Two Cases with Pathogenetic Implications

Romero‐Rojas

Bella

Meza-Cabrera

et al. 2013

Thyroid

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Background: Ectopic thyroid tissue is usually found anywhere along the embryonic descent pathway of the medial thyroid anlage from the tongue to the trachea (Wö lfler area). However, ectopic thyroid tissue in the adrenal gland (ETTAG) is not easy to understand on the basis of thyroid embryology; because it is so rare, the possibility of metastasis should first be considered. Here, we describe two cases of ETTAG with pathogenetic implications and review the associated literature. Patient findings: Two cases of ETTAG presented as incidental cystic adrenal masses in adult females, one having a congenital hernia of Morgagni. The ETTAG was histologically indistinguishable from normal orthotopic thyroid tissue, and its follicular nature was confirmed by immunohistochemical positivity for thyroglobulin, thyroperoxidase, thyroid transcription factor-1 (TTF-1/Titf-1/Nkx2.1), cytokeratin AE1/AE3, cytokeratin 7, pendrin, human sodium iodide symporter, paired box gene 8, and forkhead box E1 (TTF-2), as well as positivity for the messenger RNA of the thyroglobulin gene by in situ hybridization analysis. No C cells (negativity for calcitonin, chromogranin, and synaptophysin) were present. Neither BRAF nor KRAS mutations were detected with real-time polymerase chain reaction analysis. Further work-up did not show evidence of thyroid malignancy. Summary: ETTAG is a rare finding, with only seven cases reported; women are much more frequently affected than men (8:1), and it usually presents in the fifth decade (mean age 54, range 38-67) as a cystic adrenal mass incidentally discovered on abdominal ultrasonography and/or in computed tomography images. ETTAG is composed of normal follicular cells without C cells. The expression of some transcription factors (TTF-1, paired box gene 8, and FOXE1) involved in development and/or migration of the medial thyroid anlage is preserved. Coexistence of a congenital hernia of Morgagni in one patient suggests an overdescent of medial thyroid anlagederived cells in its pathogenesis. Conclusion: Although ETTAG pathogenesis remains unknown, the lack of C cells together with the coexistence of a congenital defect of the anterior diaphragm (hernia of Morgagni) in one of our patients could suggest an overdescent of medial thyroid anlage-derived cells in the origin of this heterotopia.

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“…As our search of the literature revealed published examples from countries as distant apart as Himalaya [5] , Czeck Republic [7] , India [8] , Italy [9] , Japan [10] , Korea [11] , Turkey [12] , and USA [13,14] , we deem it interesting to add our Nigerian case. Moreover, it is in keeping with the advice from a British Research Group [15] to the effect that a histopathology data pool is useful in epidemiological analysis.…”

Section: Discussionmentioning

confidence: 99%

CASE REPORT Heterotopic thyroid tissue of the uvula

Onuigbo¹,

Okoroafor

2014

CRCP

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It is acknowledged that the uvula's "structure's function appears in the literature in only the briefest fashion". It has also been declared that "Disorders of the palatal uvula are one of the least highlighted areas of medical literature". Therefore, we present a most rare case of heterotropic thyroid tissue found in this organ in Nigeria. It is an addition to the worldwide appreciation of this unique entity.

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Ectopic thyroid in an adrenal mass: a case report

Cited by 40 publications

References 8 publications

Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity

Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity

Ectopic Thyroid Tissue in the Adrenal Gland: A Report of Two Cases with Pathogenetic Implications

CASE REPORT Heterotopic thyroid tissue of the uvula

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