Gurleyik Emin, Dogan Sami, Cetin Fuat, Gursoy Fatih, Ipor Alper M
Department of Surgery, Duzce University Medical Faculty.
Cureus. 2017 Sep 17;9(9):e1695. doi: 10.7759/cureus.1695.
Thyroid hemiagenesis (TH) is a rare congenital anomaly that is usually asymptomatic. Functional disorders of the thyroid make the patient symptomatic. TH is usually and incidentally established during evaluation of patients with symptomatic thyroid pathology. We report the case of a patient of TH who became symptomatic with hyperactivity of the gland. The patient presented with signs and symptoms of thyrotoxicosis. Physical examination revealed asymmetric nodular goiter at the right lobe. Biochemical analysis established the diagnosis of hyperthyroidism. Ultrasound of the thyroid gland revealed the absence of the left lobe and a large, solitary hypoechoic solid nodule in the right lobe. Nuclear scan showed the absence of the left lobe and revealed a large, autonomous solitary nodule in the right lobe. The diagnosis was a toxic adenoma. After medical control of hyperthyroidism, the patient was surgically treated with hemithyroidectomy. We prescribed postoperative replacement medication with L-thyroxin. Hyperthyroidism makes TH cases symptomatic. Thyroid ultrasound and scintigraphy incidentally discover agenesis of one lobe during evaluation of thyrotoxicosis. Hemithyroidectomy, including the autonomous nodule, is the procedure of choice for patients with toxic adenoma. Hemithyroidectomy in TH cases technically becomes a total thyroidectomy with a need for postoperative thyroid replacement therapy.
甲状腺半侧缺如（TH）是一种罕见的先天性异常，通常无症状。甲状腺功能障碍会使患者出现症状。TH通常是在对有症状的甲状腺疾病患者进行评估时偶然发现的。我们报告一例TH患者，其甲状腺出现功能亢进症状。该患者表现出甲状腺毒症的体征和症状。体格检查发现右叶有不对称性结节性甲状腺肿。生化分析确诊为甲状腺功能亢进。甲状腺超声检查显示左叶缺如，右叶有一个大的、孤立的低回声实性结节。核素扫描显示左叶缺如，右叶有一个大的自主性孤立结节。诊断为毒性腺瘤。在对甲状腺功能亢进进行药物控制后，该患者接受了甲状腺半切除术。我们开了术后左甲状腺素替代药物。甲状腺功能亢进使TH病例出现症状。在评估甲状腺毒症时，甲状腺超声和闪烁扫描偶然发现一侧叶缺如。对于毒性腺瘤患者，包括自主性结节的甲状腺半切除术是首选手术方式。在TH病例中，甲状腺半切除术在技术上变成了全甲状腺切除术，术后需要进行甲状腺替代治疗。
