Ectopic lingual thyroid presenting as massive bleeding in a high-risk surgical patient treated with radioactive iodine

Abstract

Lingual thyroid ectopia is a rare congenital abnormality affecting embryogenesis of the gland descent from the foregut through the pre-tracheal region in the neck. Most cases have an asymptomatic course but may occasionally produce local obstructive symptoms such as dysphagia, dysphonia, dyspnea, pain, or a complication such as bleeding tissues. Diagnostic methods include 99mTc, 123I radionuclide scan, computed tomography scan, magnetic resonance, and ultrasound. No treatment is needed for euthyroid asymptomatic patients unless they present hypothyroidism, which will be treated with LT4. The conventional surgery approach is the elective treatment for cases presenting complaints or complications. Radioactive iodine ablation is the alternative option for patients who refuse surgical intervention or are unfit for anesthesia. We report the case of a 49-year-old woman with an ectopic lingual thyroid presented as oral hemoptysis. Due to the high surgical risk associated with the patient's comorbidities, she successfully received treatment with 592 MBq of 131I.