Orthotopic Thyroid Research Articles

Intratracheal Ectopic Thyroid Tissue Mimicking a Subglottic Mass in a Patient With Thyroid Follicular Carcinoma on SPECT/CT.

Intratracheal ectopic thyroid tissue is an extremely rare condition with limited cases reported in the literature. It can be asymptomatic or present with symptoms such as dysphagia, bleeding, dysphonia, dyspnea, and a sensation of a foreign body in the throat, depending on its localization. Due to its various clinical presentations, it poses a diagnostic dilemma. Herein, we aimed to present the contribution of thyroid scintigraphy and SPECT/CT to the diagnosis and management of a case with follicular carcinoma in the orthotopic thyroid gland as well as an ectopic intratracheal thyroid causing cough and airway obstruction mimicking a subglottic mass.

Triple Ectopic Thyroid Gland in a Patient With Dysphagia, Without Orthotopic Thyroid Gland.

Triple Ectopic Thyroid Gland in a Patient With Dysphagia, Without Orthotopic Thyroid Gland.

RAS-RAF-miR-296-3p signaling axis increases Rad18 expression to augment radioresistance in pancreatic and thyroid cancers

Oncogenic RAS and RAF signaling has been implicated in contributing to radioresistance in pancreatic and thyroid cancers. In this study, we sought to better clarify molecular mechanisms contributing to this effect. We discovered that miRNA 296–3p (miR-296–3p) is significantly correlated with radiosensitivity in a panel of pancreatic cancer cells, and miR-296–3p is highly expressed in normal cells, but low in cancer cell lines. Elevated expression of miR-296–3p increases radiosensitization while decreasing the expression of the DNA repair enzyme RAD18 in both pancreatic and thyroid cancer cells. RAD18 is overexpressed in both pancreatic and thyroid tumors compared to matched normal controls, and high expression of RAD18 in tumors is associated with poor prognostic features. Modulating the expression of mutant KRAS in pancreatic cancer cells or mutant BRAF in thyroid cancer cells demonstrates a tight regulation of RAD18 expression in both cancer types. Depletion of RAD18 results in DNA damage and radiation-induced cell death. Importantly, RAD18 depletion in combination with radiotherapy results in marked and sustained tumor regression in KRAS mutant pancreatic cancer orthotopic tumors and BRAF mutant thyroid heterotopic tumors. Overall, our findings identify a novel coordinated RAS/RAF-miR-296-3p-RAD18 signaling network in pancreatic and thyroid cancer cells, which leads to enhanced radioresistance.

AIUM Practice Parameter for the Performance and Interpretation of Diagnostic Ultrasound of the Thyroid and Extracranial Head and Neck.

AIUM Practice Parameter for the Performance and Interpretation of Diagnostic Ultrasound of the Thyroid and Extracranial Head and Neck.

LBODP103 Ectopic Thyroid Tissue In A Pediatric Patient After Total Thyroidectomy

Abstract Introduction Ectopic thyroid tissue is defined as any functional thyroid tissue outside the normal anatomical location. It is rare and occurs with a frequency of 1 in 100,000-300,000. Most commonly, it is located along the normal track of thyroid development along the floor of the primitive gut to the pre-tracheal region of the neck; however, rarely it has been found in other areas. Malignancy is very rare in ectopic thyroid tissue (<1%) and when it occurs, papillary carcinoma is the most common type. Maki et al have reported multiple cases of lateral neck ectopic thyroid tissue in the presence of an orthotopic thyroid gland in the adult population. Only 2 pediatric cases have been reported in the literature so far. Clinical Case A 11-year-old male presented with concerns of morbid obesity and a neck swelling. He endorsed a previous history of thyroid nodules measuring over 2 cm that were being monitored by his previous endocrinologist. On exam, he was noted to have a goiter. Labs were obtained which indicated normal thyroid function tests (TSH 3. 040 uIU/mL, nl 0.45-4.5 uIU/mL and free T4 0.96 ng/dL, nl 0.93-1.6 ng/dL) and negative anti thyroid antibodies (TPO antibody <9 IU/mL, nl 0-26 IU/mL and thyroglobulin ab <1 IU/mL, nl 0. 0-0.9 IU/mL). His previous medical records revealed that a FNA was completed 2 years prior which was reported as benign. A repeat thyroid ultrasound revealed a multinodular goiter with 5 nodules measuring 3.3 x1.5×1.3cm and 5×6×5mm in the right lobe and 7×6×4cm, 2.4×2.1×1.8cm, and 5×6×5cm in the left lobe. After reviewing different management approaches, the family preferred thyroidectomy. He was referred to general surgery and subsequently underwent total thyroidectomy. Post-operatively, he was started on levothyroxine and calcium carbonate supplementation. The calcium supplementation was subsequently weaned and discontinued. Final pathology was reported as benign. Unfortunately, he was lost to follow up and presented to his primary care provider 6 months post-operatively with continued weight gain and a right sided neck mass. Labs obtained showed an elevated TSH (9.820 uIU/mL, nl 0.45-4.5 uIU/mL) and normal free T4 (1. 07 ng/dL, nl 0.93-1.6 ng/dL). Ultrasound of the neck revealed a 2.5 cm heterogeneous nodule in the right neck adjacent to the thyroid bed, concerning for recurrent/residual disease. FNA was completed and was consistent with normal appearing thyroid tissue. Ultrasound monitoring will continue to assess for change in size and need, if any for surgical removal in the future. Discussion Ectopic thyroid tissue with an orthotopic thyroid is a very rare finding in the pediatric population. Ectopic thyroid tissue outside of the thyroglossal duct is rare as well. We present an 11-year-old male who underwent thyroidectomy for multiple large thyroid nodules and subsequently developed a new neck mass diagnosed as ectopic thyroid tissue. Presentation: No date and time listed

Ectopic thyroid carcinoma in the mandible with normally located goiterous thyroid gland: A case report.

BackgroundThe presence of ectopic thyroid tissue is a developmental disorder that affects about one per 100,000–300,000 people. It is extraordinarily rare for ectopic thyroid to be out of the lines of its descent. This case is the first to report a cancerous ectopic thyroid in the mandibular bone with a goitrous orthotopic thyroid gland.Case presentation80-year-old female of free medical background presented to our clinic with painless left mandibular swelling that recent increase in size after tooth extraction. Surprisingly the diagnosis of ectopic thyroid tissue with cancerous follicular cells was reached upon histological analysis. The goitrous thyroid gland was found in its expected cervical location, and the patient was euthyroid.ConclusionBecause this diagnosis extremely rare, the possibility of ectopic thyroid carcinoma in cases of a pathological mass in the mandible must always be carefully thought out. A high degree of suspicion is essential as the unusual presentation could take.

Accessory Thyroid Tissue Detected Using 131 I SPECT/CT Imaging.

Thyroid ectopia has been described as a rare congenital anomaly, characterized by the presence of a thyroid gland in locations other than the orthotopic pretracheal location. The prevalence of accessory thyroid tissue in patients undergoing postablative radioiodine therapy in a 12-month period at a tertiary hospital nuclear medicine department was assessed. Fifty-seven patients were treated between September 2020 and September 2021. Retrospective analysis identified the presence and location of all accessory thyroid tissue separate from the orthotopic pretracheal thyroid gland. Accessory thyroid tissue was present in 21.1% (12/57) of the patients. Accessory thyroid tissue was most commonly located in the lingual region.

Benign Intratracheal Thyroid: A Systematic Review of 43 Cases With Five New Case Reports

Objective/HypothesisTo examine the clinical features of benign intratracheal thyroid (ITT) and their management strategies and outcomes.Study DesignCase series study.MethodsThis systemic review was conducted in two international academic centers. This review includes 43 patients: one new case from the Massachusetts Eye and Ear Infirmary, four new cases from Beijing Tongren Hospital, and 38 previously published cases. We analyzed these 43 cases and summarized the patients' epidemiological data, clinical features, and treatment regimens.ResultsITTs were less common in men than in women (male:female ratio of 3:10). ITT was observed in patients as young as neonates and as old as 85 years. Orthotopic thyroid nodules were present in 55.8% of the patients with ITT. Malignancy was incidentally found in 4.6% of all ITTs. Imaging examinations showed that the ITTs were typically attached to the posterolateral/lateral tracheal wall of the first, second, or third tracheal rings. Tissue attachment between the ITT and normal thyroid lobes was seen in 59.5% of the patients. Thirty‐seven patients underwent surgery: 30 underwent open surgery, and seven underwent endoscopic debulking resections. One neonate received thyroid suppression therapy. One patient with ITT and papillary thyroid cancer was treated with radiotherapy and ultimately died after recurrence.ConclusionsSurgical resection is an effective treatment for benign ITT. We hypothesized that abnormalities during the embryonic development of Berry's ligament might play a role in ITT pathogenesis.Level of EvidenceNA Laryngoscope, 131:E2609–E2617, 2021

A High-throughput Approach to Identify Effective Systemic Agents for the Treatment of Anaplastic Thyroid Carcinoma.

Despite the use of aggressive multimodality treatment, most anaplastic thyroid carcinoma (ATC) patients die within a year of diagnosis. Although the combination of BRAF and MEK inhibitors has recently been approved for use in BRAF-mutated ATC, they remain effective in a minority of patients who are likely to develop drug resistance. There remains a critical clinical need for effective systemic agents for ATC with a reasonable toxicity profile to allow for rapid translational development. Twelve human thyroid cancer cell lines with comprehensive genomic characterization were used in a high-throughput screening (HTS) of 257 compounds to select agents with maximal growth inhibition. Cell proliferation, colony formation, orthotopic thyroid models, and patient-derived xenograft (PDX) models were used to validate the selected agents. Seventeen compounds were effective, and docetaxel, LBH-589, and pralatrexate were selected for additional in vitro and in vivo analysis as they have been previously approved by the US Food and Drug Administration for other cancers. Significant tumor growth inhibition (TGI) was detected in all tested models treated with LBH-589; pralatrexate demonstrated significant TGI in the orthotopic papillary thyroid carcinoma model and 2 PDX models; and docetaxel demonstrated significant TGI only in the context of mutant TP53. HTS identified classes of systemic agents that demonstrate preferential effectiveness against aggressive thyroid cancers, particularly those with mutant TP53. Preclinical validation in both orthotopic and PDX models, which are accurate in vivo models mimicking tumor microenvironment, may support initiation of early-phase clinical trials in non-BRAF mutated or refractory to BRAF/MEK inhibition ATC.

Abstract #1002367: A Complicated Case of Ectopic Thyroid Neoplasm in Mediastinal Mass with Benign Pathology in Orthotopic Thyroid Gland

Abstract #1002367: A Complicated Case of Ectopic Thyroid Neoplasm in Mediastinal Mass with Benign Pathology in Orthotopic Thyroid Gland

An unusual case of struma ovarii.

IntroductionStruma ovarii is a teratoma of the ovaries predominantly composed of thyroid tissue. Hyperthyroidism associated with struma ovarii is rare, occurring in approximately 8% of cases. Due to the rarity of struma ovarii, available data are limited to case reports and small case series.Methods and resultsWe report on a 61-year-old female patient with known Hashimoto’s thyroiditis on levothyroxine replacement therapy for years with transition to clinical and biochemical hyperthyroidism despite antithyroid medication with carbimazole (10 mg/day), new diagnosis of urothelial carcinoma and an adnexal mass suspicious of ovarian cancer. The patient underwent resection of the adnexal mass and histopathology revealed a mature teratoma predominantly composed of thyroid tissue showing high levels of sodium iodide symporter protein expression. Following struma ovarii resection and disappearance of autonomous production of thyroid hormones, the patient developed hypothyroidism with severely decreased thyroid hormone levels fT4 and fT3 (fT4 0.4 ng/dL, reference interval 0.9–1.7 and fT3 < 1.0 pg/mL, reference interval 2.0–4.4). This has previously been masked by continued thyroid-stimulating hormone suppression due to long-term hyperthyroidism pre-surgery indicating secondary hypothyroidism, in addition to primary hypothyroidism based on the known co-existing chronic lymphocytic thyroiditis of the orthotopic thyroid gland. Levothyroxine administration was started immediately restoring euthyroidism.ConclusionThis case illustrates possible diagnostic pitfalls in a patient with two concurrent causes of abnormal thyroid function.Learning pointsStruma ovarii is an ovarian tumor containing either entirely or predominantly thyroid tissue and accounts for approximately 5% of all ovarian teratomas.In rare cases, both benign and malignant struma ovarii can secrete thyroid hormones, causing clinical and biochemical features of hyperthyroidism.Biochemical features of patients with struma ovarii and hyperthyroidism are similar to those of patients with primary hyperthyroidism. In such cases, thyroid scintigraphy should reveal low or absent radioiodine uptake in the thyroid gland, but the presence of radioiodine uptake in the pelvis in a whole body radioiodine scintigraphy.We give advice on possible diagnostic pitfalls in a case with two simultaneous causes of abnormal thyroid function due to the co-existence of struma ovarii.

Detecting Immune Response to Therapies Targeting PDL1 and BRAF by Using Ferumoxytol MRI and Macrin in Anaplastic Thyroid Cancer.

Background Anaplastic thyroid cancer (ATC) is aggressive with a poor prognosis, partly because of the immunosuppressive microenvironment created by tumor-associated macrophages (TAMs). Purpose To understand the relationship between TAM infiltration, tumor vascularization, and corresponding drug delivery by using ferumoxytol-enhanced MRI and macrin in an ATC mouse model. Materials and Methods ATC tumors were generated in 6-8-week-old female B6129SF1/J mice through intrathyroid injection to model orthotopic tumors, or intravenously to model hematogenous metastasis, and prospectively enrolled randomly into treatment cohorts (n = 94 total; August 1, 2018, to January 15, 2020). Mice were treated with vehicle or combined serine/threonine-protein kinase B-Raf (BRAF) kinase inhibitor (BRAFi) and anti-PDL1 antibody (aPDL1). A subset was cotreated with therapies, including an approximately 70-nm model drug delivery nanoparticle (DDNP) to target TAM, and an antibody-neutralizing colony stimulating factor 1 receptor (CSF1R). Imaging was performed at the macroscopic level with ferumoxytol-MRI and microscopically with macrin. Genetically engineered BrafV600E/WT p53-null allografts were used and complemented by a GFP-transgenic derivative and human xenografts. Tumor-bearing organs were processed by using tissue clearing and imaged with confocal microscopy and MRI. Two-tailed Wilcoxon tests were used for comparison (≥five per group). Results TAM levels were higher in orthotopic thyroid tumors compared with pulmonary metastatic lesions by 79% ± 23 (standard deviation; P < .001). These findings were concordant with ferumoxytol MRI, which showed 136% ± 88 higher uptake in thyroid lesions (P = .02) compared with lung lesions. BRAFi and aPDL1 combination therapy resulted in higher tumor DDNP delivery by 39% ± 14 in pulmonary lesions (P = .004). Compared with the untreated group, tumors following BRAFi, aPDL1, and CSF1R-blocking antibody combination therapy did not show greater levels of TAM or DDNP (P = .82). Conclusion In a mouse model of anaplastic thyroid cancer, ferumoxytol MRI showed 136% ± 88 greater uptake in orthotopic thyroid tumors compared with pulmonary lesions, which reflected high vascularization and greater tumor-associated macrophage (TAM) levels. Serine/threonine-protein kinase B-Raf inhibitor and anti-programmed death ligand 1 antibody elicited higher local TAM levels and 43% ± 20 greater therapeutic nanoparticle delivery but not higher vascularization in pulmonary tumors. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Luker in this issue.

Mediastinal ectopic thyroid tissue as diferential diagnostic problem: A case report

Introduction. Mediastinal ectopic thyroid tissue (ETT) rep-resents a rare entity. Clinically, it can manifest with thyroid gland dysfunction or with symptoms and signs caused by a compressive effect on the surrounding structures, but in most cases it is an asymptomatic condition and incidental finding. All pathologic processes, including malignancy that can occur in the orthotopic thyroid gland can also develop in the ETT. Case report. We presented a case of a 17-year-old female with incidentally found mediastinal ETT. Besides ETT, the patient had an orthotopic thyroid gland and was euthyroid. During follow-up, mild compressive symptoms developed. Magnetic resonance imaging examination showed a non-significant increase of the mediastinal mass volume, but due to its morphological changes, a suspicion of another etiology was raised. A discrepancy between the positive technetium-99m pertechnetate and negative 131 iodine radionuclide imaging of the mediastinal mass was highly suspicious for malignancy. Surgery was performed and the pathologist confirmed that it was a colloid goiter in the mediastinal ETT. Conclusion. Mediastinal ectopic thyroid tissue should be taken into account in the differential diagnosis of the mediastinal tumor mass. An increase in the size of the mediastinal ETT, development of compressive symptoms or suspected malignant alteration require surgical treatment.

A Combinatorial Strategy for Targeting BRAF V600E-Mutant Cancers with BRAFV600E Inhibitor (PLX4720) and Tyrosine Kinase Inhibitor (Ponatinib).

Most aggressive thyroid cancers are commonly associated with a BRAF V600E mutation. Preclinical and clinical data in BRAF V600E cancers suggest that combined BRAF and MEK inhibitor treatment results in a response, but resistance is common. One mechanism of acquired resistance is through persistent activation of tyrosine kinase (TK) signaling by alternate pathways. We hypothesized that combination therapy with BRAF and multitargeting TK inhibitors (MTKI) might be more effective in BRAF V600E thyroid cancer than in single-agent or BRAF and MEK inhibitors. The combined drug activity was analyzed to predict any synergistic effect using high-throughput screening (HTS) of active drugs. We performed follow-up in vitro and in vivo studies to validate and determine the mechanism of action of synergistic drugs. The MTKI ponatinib and the BRAF inhibitor PLX4720 showed synergistic activity by HTS. This combination significantly inhibited proliferation, colony formation, invasion, and migration in BRAF V600E thyroid cancer cell lines and downregulated pERK/MEK and c-JUN signaling pathways, and increased apoptosis. PLX4720-resistant BRAF V600E cells became sensitized to the combination treatment, with decreased proliferation at lower PLX4720 concentrations. In an orthotopic thyroid cancer mouse model, combination therapy significantly reduced tumor growth (P < 0.05), decreased the number of metastases (P < 0.05), and increased survival (P < 0.05) compared with monotherapy and vehicle control. Combination treatment with ponatinib and PLX4720 exhibited significant synergistic anticancer activity in preclinical models of BRAF V600E thyroid cancer, in addition to overcoming PLX4720 resistance. Our results suggest this combination should be tested in clinical trials.

Pediatric thyroid ultrasound: a radiologist's checklist.

Ultrasonography (US) is the imaging method of choice for evaluating the pediatric thyroid gland, complemented by scintigraphy and thyroid function tests, especially when evaluating children with suspected congenital hypothyroidism, goiter, infectious or autoimmune diseases, or neoplasm. Diagnostic considerations in newborns with congenital hypothyroidism mainly include dysgenesis, dyshormonogenesis, transient hypothyroidism and central (hypophyseal) hypothyroidism. The midline of the neck should be scrutinized for thyroid tissue from the floor of the mouth to the thoracic inlet. Cystic and echogenic ultimobranchial remnants should not be misinterpreted as orthotopic thyroid tissue. Diffuse thyroid diseases affect older children; these comprise Hashimoto and Graves diseases and infectious thyroiditis and exhibit features similar to those in adults. It is important to note that the diffuse sclerosing variant of papillary thyroid cancer can complicate thyroiditis and should not be confused with Hashimoto disease. In children with solid nodules the threshold for fine-needle aspiration biopsy or surgery should be lower compared to adults because of a higher likelihood of malignancy compared with adults. Biopsy should be considered in nodules with suspicious ultrasonographic features, even when smaller than 1cm. Adult classification systems of thyroid nodules, although useful, are not sufficient to safely discriminate the nodules' likelihood of malignancy in children. We describe key sonographic findings and suggest a standard checklist that might be considered while performing and interpreting thyroid US in neonates and children.

Mebendazole inhibits tumor growth and prevents lung metastasis in models of advanced thyroid cancer.

The most common thyroid malignancy is papillary thyroid cancer. While a majority respond to therapy and have a favorable prognosis, some papillary thyroid cancers persist. This subset may dedifferentiate to anaplastic thyroid cancer, an aggressive, highly invasive and rapidly fatal cancer. Thyroid cancer patients at risk for disease progression and metastasis need earlier, safer and more effective therapies. The purpose of this translational study was to determine if mebendazole could be repurposed to effectively treat thyroid cancer, in particular before metastasis. In vitro, mebendazole potently inhibited the growth of a panel of human papillary and anaplastic thyroid cancer cells. In papillary (B-CPAP) and anaplastic (8505c) cell lines, mebendazole increased the percentage of cells in G2/M cell cycle arrest and induced late stage apoptosis by activation of the caspase-3 pathway. In aggressive 8505c cells, mebendazole significantly repressed migratory and invasive potential in a wound healing and transwell invasion assay and inhibited expression of phosphorylated Akt and Stat3 and reduced Gli1. In vivo, mebendazole treatment resulted in significant orthotopic thyroid tumor regression (B-CPAP) and growth arrest (8505c), with treated tumors displaying reduced expression of the proliferation maker KI67 and less vascular epithelium as indicated by CD31+ immunohistochemistry. Most importantly, daily oral mebendazole prevented established thyroid tumors from metastasizing to the lung. Given the low toxicity and published anticancer mechanisms of mebendazole, this novel preclinical study of mebendazole in thyroid cancer has promising therapeutic implications for patients with treatment refractory papillary or anaplastic thyroid cancer.

Impaired microRNA processing by DICER1 downregulation endows thyroid cancer with increased aggressiveness

The global downregulation of microRNAs (miRNAs) is emerging as a common hallmark of cancer. However, the mechanisms underlying this phenomenon are not well known. We identified that the oncogenic miR-146b-5p attenuates miRNA biosynthesis by targeting DICER1 and reducing its expression. DICER1 overexpression inhibited all the miR-146b-induced aggressive phenotypes in thyroid cells. Systemic injection of an anti-miR-146b in mice with orthotopic thyroid tumors suppressed tumor growth and recovered DICER1 levels. Notably, DICER1 downregulation promoted proliferation, migration, invasion, and epithelial-mesenchymal transition through miRNA downregulation. Our analysis of The Cancer Genome Atlas revealed a general decrease in DICER1 expression in thyroid cancer that was associated with a worse clinical outcome. Administration of the small-molecule enoxacin to promote DICER1 complex activity reduced tumor aggressiveness both in vitro and in vivo. Overall, our data confirm DICER1 as a tumor suppressor and show that oncogenic miR-146b contributes to its downregulation. Moreover, our results highlight a potential therapeutic application of RNA-based therapies including miRNA inhibitors and restoration of the biogenesis machinery, which may provide treatments for thyroid and other cancers.

Papillary Thyroid Carcinoma with Cervical Lymph Node Metastasis Arising from Lingual Thyroid.

Although lingual thyroid is the most common site for ectopic thyroid gland but carcinomas originating from lingual thyroid are extremely rare, accounting only for 1% of all ectopic thyroids. Here we represent a young female with a bleeding mass at the base of her tongue and review the diagnostic approach towards papillary thyroid carcinoma of lingual thyroid. The surgical treatment and follow up are discussed. A combination of radiological studies and histological evaluation should be deployed to investigate suspicious lingual thyroids. The perspective of diagnostic and therapeutic approaches for carcinomas of lingual thyroid is the same as orthotopic thyroid tissue.

An unexpected finding from a submental mass.

This case describes a fit and well 17-year-old male who underwent surgical resection of a longstanding, painless, right lateral neck swelling. Believed to be either a vascular malformation, ranula or enlarged sublingual gland from pre-operative MR studies, histopathological examination of the mass revealed it as normal thyroid tissue. Post-operative imaging confirmed the absence of any remaining thyroid tissue. Hypothyroidism was confirmed with subsequent thyroid function tests. Interestingly, a “thyroid storm” which presented unknowingly during the surgical removal of the lesion did not trigger suspicion that thyroid tissue was being handled at the time. Normal, ectopic thyroid tissue in the lateral neck is rare but should be considered a differential diagnosis for neck lumps, particularly if it also presents as an intraoral swelling, as in this case. The presence of the orthotopic thyroid gland should be confirmed with diagnostic imaging prior to surgical excision of unknown neck masse

Ectopic submental thyroid tissue, with no evidence of orthotopic thyroid: a case report

Background: Thyroid ectopia refers to a congenital disease with abnormal descending of the thyroid gland. The most common subtype is lingual thyroid ectopia. Sublingual and submental thyroid ectopia are much less common. It may also be found in other neck locations and distant positions .70%–90% of patients with ectopic thyroid do not have eutopic thyroid tissue. It is necessary to distinguish ectopic thyroid from other causes of neck masses. Case Presentation: A 18-year-old man was referred for the evaluation of a palpable mass in the submental region. On biochemical examination, the thyroid function tests were normal while receiving levothyroxine therapy. Ultrasonography revealed a mass measuring 4.2 × 2.7 × 2.6 cm in the submental region. The thyroid scan did not show any uptake in the thyroid region. A zone of the tracer activity was noted in the central neck, compatible with the palpated mass in the submental region. CT images showed a hyperdense soft tissue in the submental region, too. Conclusion: Thyroid ectopia is a rare condition and it is often accompanied by hypothyroidism. Ectopia often occurs in lingual and sublingual locations, and submental one is less common. Thyroid scintigraphy is the best imaging modality for the detection of thyroid ectopia. For precise localization, the CT scan correlation may be needed.