lingual thyroid
Introduction
Introduction to the tongue thyroid During embryonic development, part or all of the thyroid gland does not descend and stays in the blind hole of the tongue, which becomes the tongue thyroid gland. The thyroid gland with a normal position in the neck and the thyroid gland is also known as the parathyroid gland. Thyroid tissue is concentrated in the base of the tongue and there is no thyroid in the normal position of the neck. It is also called vagus thyroid. This disease is rare in children. Sexual maturity, pregnancy, and lactation are more common. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: obstructive sleep apnea syndrome
Cause
Tongue thyroid cause
During embryonic development, the thyroid primordial solid cell mass is borrowed from the thyroid sac, and the tubule formed by the remainder (the thyroid tongue) extends downward to the normal thyroid position, if the thyroid gland does not descend or only partially descends to the neck. The normal position in front of the trachea forms an ectopic thyroid.
Prevention
Tongue thyroid prevention
ETG can be a benign or malignant tumor like a normal thyroid gland. A malignant tumor can also undergo lymph node and systemic metastasis. ETG tumor should be surgically removed as soon as possible. For benign thyroid tumor, the parathyroid gland can be completely removed, and the thyroid gland benign tumor can be considered. It is advisable to perform intracapsular resection to preserve part of the thyroid tissue to avoid hypothyroidism. The malignant tumor of ETG should be determined according to the general condition of the patient, whether there is metastasis or local condition of the tumor.
Complication
Tongue thyroid complications Complications, obstructive sleep apnea syndrome
Can be complicated by sleep apnea syndrome, affecting the quality of sleep, thus affecting people's quality of life. Due to the appearance of snoring, patients can have headaches, dizziness and other complications the next morning after sleeping. Due to the odor of thyroid tissue, it can stimulate the thyroid tissue to secrete excessive thyroxine. Therefore, in some cases, the thyroid function test shows an increase in T3 and T4. But TSH does not fall.
Symptom
Tongue thyroid symptoms common symptoms sore throat cysts, foreign body pharyngeal dysphagia, difficulty breathing, mirror tongue
It is often asymptomatic in the early stage, but the following symptoms can occur when the mass grows rapidly:
1. Obstructive symptoms: such as poor swallowing, pharyngeal foreign body sensation, unclear pronunciation, poor breathing or difficulty breathing.
2. Sore throat and bleeding: Sometimes the first symptom is bleeding.
3. Thyroid disease-like symptoms: such as hyperthyroidism or hypothyroidism.
Check visible:
1. The mass is located in the blind hole of the tongue, the size is different, there is no adhesion with the epiglottis, the base is wide, semi-circular or elliptical, the surface is covered with normal mucosa or small blood vessels are dilated, the puncture can extract a small amount of blood, the biopsy can cause the surface Erosion, infection and bleeding, it is generally not recommended for biopsy.
2. Taking the radioisotope 131 iodine, determine whether the lingual root mass is the thyroid tissue and the presence or absence of thyroid in the normal position of the neck by isotope scanning.
Examine
Tongue thyroid examination
At the time of physical examination, the ectopic thyroid gland is located in the midline of the tongue and epiglottis. It is a hemisphere or nodular protrusion, dark red, clear boundary with normal mucosa, elastic, medium hardness, cervical ectopic thyroid is located on the hyoid bone, lower midline Upper, the texture is slightly hard, the boundary is clear, it can move with swallowing, the mass is located in the blind hole of the tongue, the size is different, there is no adhesion with the epiglottis, the base is wide, semi-circular or elliptical, and the surface is covered with normal mucosa or small blood vessels. Expansion, puncture can extract a small amount of blood, biopsy can cause surface erosion, infection and bleeding, so generally do not advocate biopsy.
The laboratory examination methods include ultrasonography, radionuclide 131I thyroid scan and iodine function test, CT and MRI, among which the radionuclide 131I thyroid scan and 131I functional test determine the condition and normal parts of the thyroid gland and its function, with specificity. The significance of the decision, taking radioisotope 131 iodine, through the isotope scan to determine whether the tongue root mass is thyroid tissue and the presence of thyroid in the normal position of the neck.
Diagnosis
Tongue thyroid diagnosis
According to the typical clinical symptoms, it is not difficult to make a diagnosis by examining the findings and isotope scans, but it should be distinguished from the tumors such as the hemangioma of the tongue, the cyst of the tongue, and the tumor of fibroids.
Tongue root mass
The study suggests that 10% of the population has thyroid tissue at the base of the tongue. It is rarely reported in many cases because of asymptomatic disease. In the case of puberty, pregnancy and trauma, infection, etc., due to the increased demand for thyroxine in the body, Increases TSH and causes thyroid enlargement of the tongue. It can manifest symptoms of pharyngeal discomfort, foreign body sensation, difficulty in swallowing and breathing, and ambiguity in speech. Sometimes there may be local bleeding, and solid masses may appear in the root of the tongue. The boundary is clear, the quality is soft, the surface is smooth or irregular, and the possibility of ETG should be thought of when there is a mass of the tongue.
Thyroglossal cyst
The thyroglossal cyst is a common disease of the otolaryngology. The pre-neck ETG, especially the parathyroid gland, is easily misdiagnosed as a thyroglossal cyst. The thyroglossal cyst is mostly located in the middle of the neck between the hyoid bone and the thyroid. Round mass, sexy capsule, clear border, no tenderness, and can move up and down with swallowing, but its performance after a secondary infection can be atypical, ETG can also move up and down with swallowing, mostly solid mass, but also It may be sac sexy due to degeneration or hemorrhage, but it is not as obvious as thyroglossal cyst. The puncture fluid is mostly dark brown bloody fluid, while the thyroglossal cyst is usually yellow liquid. The radionuclide scanning ETG has iodine absorption function and thyroid. The tongue tube cyst lacks iodine absorption.
