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Lingual Thyroid Ectopia: Diagnostic SPECT/CT imaging and Radioactive Iodine Treatment.
Thyroid. 2016 Feb 11;
Authors: Gandhi A, Wong KK, Gross M, Avram A
Abstract
BACKGROUND: Lingual thyroid is a rare abnormality of thyroid development that is usually treated conservatively with levothyroxine replacement. Rarely, it becomes large enough to cause obstructive symptoms in the oral cavity, requiring definitive treatment.
PATIENT FINDINGS: We report 3 patients with lingual thyroid treated with radioactive iodine-131 (<sup>131</sup>I) with successful radioablation of their ectopic thyroid tissues. Measurement of 24 hour radioactive iodine uptake (RAIU) within thyroidal tissues and hybrid SPECT/CT imaging using either iodine-123 (<sup>123</sup>I) or technetium-99m pertechnetate (<sup>99m</sup>Tc) scans were performed in all patients demonstrating the location and size of lingual thyroid and absence of an orthotopic thyroid gland.
SUMMARY: The aim of this study is to describe non-surgical management of obstructive lingual thyroid tissue with <sup>131</sup>I therapy for lingual thyroid radioablation. Patients were prepared with a low iodine diet and levothyroxine (L-T4) withdrawal prior to radioablation for optimizing <sup>131</sup>I uptake in ectopic thyroid tissues. Hybrid SPECT/CT measurement of anatomic size of lingual thyroid tissue and RAIU guided selection of therapeutic doses, resulting in administration of 10.7, 17.5, and 15.4 mCi of <sup>131</sup>I respectively. There were no post-therapy complications, and clinical follow-up demonstrated resolution of obstructive oropharyngeal symptoms.
CONCLUSIONS: Ectopic lingual thyroid tissue is rarely associated with obstructive oropharyngeal symptoms due to progressive enlargement. Radioiodine therapy with <sup>131</sup>I is an effective treatment modality for ablation of ectopic thyroid tissue as an alternative to surgery.
PMID: 26864253 [PubMed - as supplied by publisher]
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