Abstract

BackgroundLingual thyroid is a very rare pathological finding and is usually incidentally discovered. It occurs when a defect in embryogenesis gives rise to ectopic thyroid as tongue base mass. Majority of patients are asymptomatic. This clinical case highlights the importance of performing thyroid function tests for all lingual thyroid patients regardless of symptoms or clinical presentation.Case presentationWe present a 25-year-old lady who presented with sub-mental abscess. A CT scan was performed to confirm the diagnosis. The CT scan confirmed submental abcess and incidentally discovered lingual thyroid along with absence of thyroid tissue in its normal pretracheal position. The patient denied any symptoms of hypothyroidism. But subsequent investigations revealed clinical hypothyroidism. She was started on substitutive hormone therapy and remains asymptomatic.ConclusionLingual thyroid patients may remain asymptomatic with subclinical hypothyroidism. Hormone therapy needs to be initiated in these patients.

Highlights

  • Lingual thyroid is a very rare pathological finding and is usually incidentally discovered

  • In these patients, lingual thyroid is detected during the diagnostic investigation of subclinical hypothyroidism

  • This clinical case highlights the importance of performing thyroid function tests for all lingual thyroid patients regardless of symptoms or clinical presentation

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Summary

Conclusion

Lingual thyroid patients may remain asymptomatic with subclinical hypothyroidism. Hormone therapy needs to be initiated in these patients. Key messages Patients with hypothyroidism due to ectopic thyroid may remain symptom free and only come to attention after thyroid function test are carried out. Thyroid function tests are warranted whenever lingual thyroid is diagnosed irrespective of clinical presentation

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