Khalaf Saeed, Sarwani Aysha, Al Fardan Rawdha, Maki Mohammed, Al Saeed Mahmood
Endocrinology, Salmaniya Medical Complex, Manama, BHR.
Internal Medicine, Salmaniya Medical Complex, Manama, BHR.
Cureus. 2021 Apr 3;13(4):e14271. doi: 10.7759/cureus.14271.
Hyperthyroidism is a common disease. Thyroglossal duct cysts are also a very common type of congenital anomalies. Their co-existence is, however, rare with only a few cases described in the literature of the same. We describe the case of a 44-year-old female who presented initially 16 years ago with hyperthyroid symptoms related to Graves' disease diagnosed serologically and by thyroid scan and ultrasound. Incidentally, she was also noted to have a non-complicated thyroglossal duct cyst. She was initially started on anti-thyroid medications but remained in a hyperthyroid state throughout most of her illness. Radioiodine ablative therapy and surgical resection were delayed due to the patient's dispreference. After a long period of missed follow up, she presented with a thyroid storm and underwent a total thyroidectomy and cyst resection. The key endocrine issues learned from this case include: 1) dealing with non-compliant patients in terms of poorly controlled hyperthyroidism and refusal to follow the recommended treatment, 2) observing the natural disease progression of untreated Graves' disease coexisting with a thyroglossal duct cyst, and 3) describing a rare incidental finding of a thyroglossal duct cyst coexisting with Graves' disease in the absence of ectopic hormone production. A few cases have described hyperthyroidism related to remnants of thyroid tissue in the thyroglossal duct or related to the thyroid gland. To the best of our knowledge, there are no cases reported of Graves' disease coexisting with a non-complicated thyroglossal duct cyst making our case unique and first of its kind.
甲状腺功能亢进症是一种常见疾病。甲状舌管囊肿也是一种非常常见的先天性异常类型。然而，它们同时存在的情况很罕见，文献中仅描述了少数病例。我们报告一例44岁女性，她16年前首次出现与格雷夫斯病相关的甲状腺功能亢进症状，通过血清学检查、甲状腺扫描和超声确诊。偶然发现，她还患有一个无并发症的甲状舌管囊肿。她最初开始服用抗甲状腺药物，但在大部分病程中仍处于甲状腺功能亢进状态。由于患者的偏好，放射性碘消融治疗和手术切除被推迟。经过长时间的失访后，她出现了甲状腺危象，接受了甲状腺全切除术和囊肿切除术。从这个病例中学到的关键内分泌问题包括：1）应对甲状腺功能亢进控制不佳且拒绝遵循推荐治疗的不依从患者；2）观察未治疗的格雷夫斯病与甲状舌管囊肿共存时的自然疾病进展；3）描述在无异位激素产生的情况下，格雷夫斯病与甲状舌管囊肿罕见的偶然共存情况。少数病例描述了与甲状舌管中甲状腺组织残余或甲状腺相关的甲状腺功能亢进症。据我们所知，尚无格雷夫斯病与无并发症的甲状舌管囊肿共存的病例报道，因此我们的病例独特且为首例。
