Piantanida Eliana, Compri Emanuele, Lai Adriana, Lombardi Valentina, Mule Ilaria Dalle, Gandolfo Myriam, Liparulo Luigi, Sassi Lorenza, Dionigi Gianlorenzo, La Rosa Stefano, Papanikolaou Nikolaos, Neri Carlo, Marnini Patrizio, Tanda Maria Laura, Bartalena Luigi
University of Insubria, Clinical Medicine, Ospedale di Circolo, Viale Borri, 57, Varese, 21100, Italy.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.07.2009.2136. Epub 2009 Dec 3.
The simultaneous finding of submandibular ectopic thyroid tissue and functional orthotopic thyroid gland is an extremely rare event. The present report describes the case of a woman presenting with a left submandibular mass, distant from a palpable multinodular goitre. Ultrasonography showed an ovoidal solid mass adjacent to the lower margin of the left submandibular gland. Cytological specimens showed colloid material and thyroid follicular cells with no malignant features. A preoperative CT scan demonstrated a very thin connection between the thyroid and the submandibular mass. The patient underwent total thyroidectomy and excision of the submandibular mass. The histopathological diagnosis of the thyroid tissue was multinodular goitre, and the submandibular mass was ectopic thyroid tissue showing a hyperplastic pattern. The main differential diagnosis of the submandibular mass was a metastasis from a well differentiated cancer. This case illustrates that an ectopic thyroid off the midline may not necessarily be a metastasis from a thyroid cancer.
同时发现下颌下异位甲状腺组织和功能正常的原位甲状腺是极其罕见的情况。本报告描述了一名女性患者的病例，该患者表现为左侧下颌下肿块，与可触及的多结节性甲状腺肿距离较远。超声检查显示在左侧下颌下腺下缘附近有一个椭圆形实性肿块。细胞学标本显示有胶质物质和甲状腺滤泡细胞，无恶性特征。术前CT扫描显示甲状腺与下颌下肿块之间有非常细的连接。患者接受了甲状腺全切除术和下颌下肿块切除术。甲状腺组织的组织病理学诊断为多结节性甲状腺肿，下颌下肿块为表现为增生模式的异位甲状腺组织。下颌下肿块的主要鉴别诊断是高分化癌的转移。该病例表明，中线以外的异位甲状腺不一定是甲状腺癌的转移灶。
