Huge lingual thyroid - Case report

Lingual thyroid is a rare developmental anomaly defined as the presence of thyroid tissue in the midline of the tongue base between the circumvallate papillae and the epiglottis. A 72-year-old woman presented with progressive dysphagia and occasional dyspnea of 3 months duration. She underwent emergent tracheostomy on account of acute upper airway obstruction. Physical examination showed an ovoid tumor of the tongue base. A series of examinations were performed, including thyroid function testing, Tc-99m thyroid scanning, computed tomography and magnetic resonance imaging. Lingual thyroid was diagnosed. She then underwent a suprahyoid pharyngotomy approach to excise the tumor. The operation went smoothly and the postoperative condition of the patient was uncomplicated. She was discharged from the hospital and followed in the clinics with no problem of upper airway compromise. In this report we discuss the incidence of lingual thyroid, the cause of goiter formation, and the complications related to this rare condition. We suggest that patients with lingual thyroid have regular follow- up to prevent life-threatening airway compromise.