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

Imaging of thymoma.

Background: Here we review primary intrathoracic goiter (P-ITG), a rare but potentially serious congenital entity that is distinct from the much more common secondary intrathoracic goiter. The latt...

Primary intrathoracic goiter: a rare and potentially serious entity.

Ectopic thyroid is a rare condition, and its location in the anterior mediastinum is even rarer, there having been only 5 reported cases in the past 30 years. Here, we describe 2 clinical cases and present a review of the literature regarding the etiology, embryology and clinical manifestations of ectopic thyroid.

/pdf/ectopic-thyroid-in-the-anterior-mediastinum-23cp56326i.pdf

Ectopic thyroid in the anterior mediastinum

Background

Ectopic mediastinal goiter is a rare entity that presents diagnostic and treatment challenges to the clinician.



Methods

A case of primary ectopic mediastinal goiter is presented and use of a cervical approach for excision is described herein. Additionally, precedent literature highlighting surgical treatment approaches is reviewed.



Results

The distinction between primary and secondary ectopic mediastinal goiter is significant as this indicates the vascular supply to the ectopic mass. Previous authors suggested open thoracic procedures for all primary mediastinal goiters to safely divide intrathoracic vascular supply, but favorably positioned anterior mediastinal goiter may be safely removed via cervical approach. This is the second case of primary ectopic mediastinal goiter successfully resected via cervical approach.



Conclusion

Select cases of primary mediastinal goiter may be amenable to excision via cervical approach, avoiding potential complications of open thoracic procedures. Additionally, CT-guided biopsy is an effective tool in preoperative diagnosis of anterior mediastinal masses. © 2011 Wiley Periodicals, Inc. Head Neck, 2013

Ectopic mediastinal goiter successfully managed via cervical approach: Case report and review of the literature

We present a patient with ectopic intrathoracic thyroid that was removed through a right lateral thoracotomy. Ectopic intrathoracic thyroid is a rare presentation of thyroid disease and comprises about 1% of all mediastinal tumors. Its removal usually necessitates thoracotomy or sternotomy. The relevant literature is briefly reviewed.

George Tolumis

Papers

Ectopic intrathoracic thyroid: case report.