The thyroid gland is the largest endocrine organ in our neck, located in front of the trachea and close to the breastbone. It weighs 20-30 grams. It stimulates the secretion of thyroid hormones. It is not normally palpable.
The thyroid gland is at the stage of development of the baby during pregnancy, in the 3rd-4th stage of the fetal period. begins to develop in weeks. It is the first endocrine organ to develop in the fetal period. If it cannot descend to the lower anterior region of the trachea, which is its final location, in the developmental stages, it may have remained in place at any stage of development. This condition is called ectopic thyroid. These places can be anywhere in the mouth from the base of the tongue to the mediastinum, which is the middle cavity of the rib cage.
Ectopic thyroid is one of the causes of congenital hypothyroidism, which is congenital thyroid hormone deficiency. It is a thyroid developmental disorder. Almost all of the causes of ectopic pregnancy are genetic mutations in the embryological period. Although ectopic thyroid is a very rare condition, its incidence increases up to 25 times in patients with thyroid disease. It can be seen at any age. It is mostly detected in newborn hypothyroidism scans. It is most commonly located at the root of the tongue.
Ectopic thyroid patients are generally those who are stated to have no thyroid gland or cannot be seen by ultrasonography during thyroid disease research.
Ectopic thyroid disease usually has no symptoms. In some cases, symptoms may develop depending on the location of the thyroid tissue. Sometimes, symptoms may develop due to abnormal pathologies of the misplaced thyroid. Symptoms can be seen because the ectopic thyroid tissue presses on where it is located and takes up space, or because it enlarges. In the root of the tongue, shortness of breath or difficulty in swallowing may develop. Similar symptoms may be seen in the trachea or mediastinum. However, since not all conditions that put pressure on the neck are ectopic thyroid, a detailed evaluation should be made in terms of other masses and malignancies.
Due to the insufficient development of the ectopic thyroid, its functions are also impaired. This causes the symptoms of hypothyroidism. This is why screening for hypothyroidism in newborns is so important. In the further examinations of babies with hypothyroidism, ectopic thyroid detection may also be possible.
Diagnosis of ectopic thyroid:
Diagnosis of ectopic thyroid begins with the thyroid hormone profile, as in other thyroid diseases. TSH, T3, T4 and thyroglobulin values should be examined. In ectopic thyroid patients, there may be abnormalities in thyroid hormones as well as normal values.
Thyroid scintigraphy can also be useful for locating the thyroid. Ultrasonography, MRI, or computed tomography imaging may also be required. A biopsy may be required in cases of suspected malignancy.
Treatment of ectoic thyroid:
Since hypothyroidism may develop in patients with congenital ectopic thyroid, regular follow-up is required. Because hypothyroidism is a condition that can seriously affect the mental development of the baby. Thyroid support treatments should be taken if needed.
It is also important to evaluate the patient’s symptoms and clinic in patients whose ectopic thyroid is detected later. If the patient has thyroid hormone disorders, treatment methods may vary according to the form of the disorder. In risky patients, if there is a possibility of malignancy, if bleeding has occurred, if uncontrolled hormonal conditions are constantly recurring, if ulcers have developed at the site of the ectopic thyroid, or for other reasons such as cosmetic reasons, surgical treatment can be applied. It should not be forgotten that these situations may change as a result of detailed evaluation by the physician.
Ectopic thyroid tissues are tissues that should be carefully examined as they can be confused with thyroglossal cysts or other head and neck cancers. Although the risk of developing malignancy from ectopic thyroid tissue is as low as 1%, it requires careful follow-up. Rarely, other complications such as thyroiditis can be seen. Even if symptoms do not develop in patients with ectopic thyroid tissue, the possibility of developing other complications in the process increases in direct proportion to time.