Bowen-Wright Hazel E, Jonklaas Jacqueline
Division of Endocrinology and Metabolism, Georgetown University, Washington, DC 20007, USA.
Thyroid. 2005 May;15(5):478-84. doi: 10.1089/thy.2005.15.478.
A 19-year-old woman was treated with bronchodilators for new-onset dyspnea with exercise. Her symptoms progressively worsened, culminating 4 months later in acute shortness of breath at rest. Flow-volume loops suggested a fixed obstruction and a computed tomography scan of the neck revealed a large subglottic mass. The patient underwent emergent tracheostomy and laryngoscopy and a near-obstructing intratracheal mass was found. Biopsy showed ectopic thyroid tissue. Magnetic resonance imaging of the neck showed a 1.4-cm tracheal lesion and a normally located thyroid gland. The intratracheal mass was resected endoscopically. Pathology revealed hyperplastic ectopic thyroid tissue. The patient has been maintained on thyroid hormone suppression therapy for 2 years without growth of the residual intratracheal thyroid tissue. She recently underwent a surgical palate expansion. We present this case, along with a literature review of ectopic intratracheal thyroid, its epidemiology, possible etiologies, genetic underpinnings, presentation, and treatment. The co-occurrence of an ectopic thyroid, a functioning orthotopic gland, and a high arched palate is also discussed.
一名19岁女性因运动时新发呼吸困难接受支气管扩张剂治疗。她的症状逐渐恶化，4个月后发展为静息时急性呼吸急促。流量-容积环提示存在固定性梗阻，颈部计算机断层扫描显示声门下有一个大肿块。患者接受了紧急气管切开术和喉镜检查，发现气管内有一个几乎造成梗阻的肿块。活检显示为异位甲状腺组织。颈部磁共振成像显示有一个1.4厘米的气管病变，甲状腺位于正常位置。气管内肿块通过内镜切除。病理显示为增生性异位甲状腺组织。该患者接受甲状腺激素抑制治疗2年，残余气管内甲状腺组织未生长。她最近接受了外科腭扩张术。我们报告此病例，并对气管内异位甲状腺的文献进行综述，包括其流行病学、可能的病因、遗传基础、临床表现及治疗。还讨论了异位甲状腺、功能正常的原位甲状腺以及高拱腭同时出现的情况。
