Ectopic thyroid tissue: An unusual cause of intracardiac mass

Abstract

Intracardiac ectopic thyroid tissue is an extremely rare condition, with only 37 cases reported in the English literature. We present a case of intracardiac ectopic thyroid adenoma and briefly review the published reports.

Personalized Management of Malignant and Non-Malignant Ectopic Mediastinal Thyroid: A Proposed 10-Item Algorithm Approach

“…The sample-focused analysis according to our methods identified another 37 EMT adults (22 females and 12 males; specific demographic data were not available for three cases; mean age was of 56.32 years, females subgroup: mean age of 56.04, range: 30-80 years; males subgroup: average age of 56.83, range: 31-74 years; across 35 articles featuring a single case study and two articles introducing each two subjects [74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93]), whereas benign EMTs were associated with a normal thyroid panel in terms of function, negative autoimmunity, and lack of nodules/cancer/goiter in eutopic (cervical) gland before and after EMT removal or identification if the EMT was not resected (of note, we also, included the cases whereas no specific thyroid data were provided, thus, it was presumably normal) [13,29, (Table 3). Regardless of the pathological traits, awareness of EMTs is essential, while removal was decided in most of the cases (rather than conservative approach) depending on the location and EMT anatomical features; the risk of malignancy (the rate of conversion from benign to a malignant EMT is not clearly understood, especially in long standing goiter-like EMT); the ectopic tissue enlargement with compressive symptoms/signs such as respiratory obstruction or compression on mediastinal organs; the risk of hemorrhage [84]; the patient's co-morbidities and medical/surgical history as well as the general health status [7,13].…”

“…CT scan represented the most important and the mostly used imagery evaluation, and it was a mandatory step of approaching (suspected or confirmed) EMTs [7,11,13,29,35,37,42,48,55,[58][59][60][61][62][63]70,71,[73][74][75][76]79,80,82,89,92,93,95,96,100,102,103,105,106,[117][118][119][120][121][122]124,125,129]. The largest diameter varied from 1 to 15 cm; no correlation between the size and a malignancy trait in EMTs could be established.…”

“…The size groups (according to the largest diameter via our practical perspective) may be regarded as follows: <2 cm [22,59,81,89,118]; between ≥2 cm and <3 cm [11,35,55,83]; between >8 cm and <10 cm [13,73,102,117]; more than 12 cm [37,45,60,115]. The most common groups were as follows: between ≥3 cm and <5 cm [9,58,62,80,85,86,93,95,103,106,119]; between ≥5 cm and <6 cm [29,74,78,79,98,100,121,122]; between ≥6 cm and <8 cm [50,55,64,70,75,82,84,88,92,100,120,123,…”

“…Intra-cardiac/intra-pericardial EMTs represent a challenging situation; however, an adequate intervention might provide a good outcome [29,79,82,83,86,89,90,119]. Kocaman et al [82] reported in 2020 an intra-pericardial EMT, while in 2018, an adult case of EMT near the left atrium in a renal cancer survivor was introduced [86].…”

“…Original Reference Number sternal (chest) pressure/pain [9,73,75,76,86,90,93,96,103,115,126,130] cough [7,9,13,50,55,69,74,75,80,91,100,102,115,129] dysphagia [9,66,76,94,96,117,126] dyspnea [9,50,63,69,73,74,77,79,85,87,91,94,97,102,117,125,129] precordial pain [119] radiating neck pain…”