A FEMALE WITH LINGUAL THYROID

Abstract

INTRODUCTION
Lingual thyroid is a rare condition that involves defective embryogenesis of the thyroid gland. Its specific prevalence accounts for a single case in 100,000-300,000. The clinical presentation varies from mild dysphagia to severe upper airway obstruction.

CASE
A 20-year-old female noticed a mass at posterior lingual since 10 years ago. She remarked the mass grows over time and and she experienced mild dysphagia. Physical examination reveals a mass at the posterior lingual that moves with deglutition. Her head and neck computed tomography with contrast showed a high density 2.6x2.2x2 cm soft tissue mass posterior to the tongue which narrowed the airway to a diameter size 0.4 cm. She underwent partial lingual thyroidectomy followed by levothyroxine therapy. Thyroid function test preoperative was FT4 1.29 mg/dl (0.89-1.76); TSH 17.049 μIU/ml (0.55- 4.78); T3 total 1.27 mg/dl (0.6-1.81) and postoperative was FT4 1.02 mg/dl (0.89-1.76); TSH 10.901 μIU/ml (0.55- 4.78); T3 total 1.06 mg/dl (0.6-1.81). Histopathologic examination showed thyroid follicles.

CONCLUSION
Lingual thyroid is a rare manifestation which may present as dysphagia. Any specific complication will be preventable with prompt diagnosis and treatment.