Ectopic Thyroid Tissue in Submandibular Region
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This case was published in MAMC journal of medical sciences

Ectopic thyroid is the presence of gland at any location except for its normal position in the anterior neck in front of the trachea. It may result from an early arrest of migration or migration along an abnormal path. Ectopic thyroid in the submandibular region is relatively unusual and may or may not be accompanied with the orthotopically located thyroid gland.

A 16-year-old female presented with a history of swelling in the anterior aspect of the neck since birth. The swelling gradually increased in size and eventually caused mild difficulty in swallowing food at the time of presentation.

On clinical examination, a 4 × 4 cm well-defined mass lesion was noted in the anterior upper neck in the midline. On laboratory investigations, she was found to be hypothyroid with a borderline decrease in her T3 levels − 1.6 nmol/L (reference range 1.3–3.1 nmol/L) and T4 levels − 72 nmol/L (reference range 66–181 nmol/L) and markedly elevated thyroid stimulating hormone (TSH) level − 112.7 μIU/mL (reference range 0.27–4.2 μIU/mL), respectively.

On USG, there was a well-defined heterogeneous, predominantly hypoechoic mass seen in the submandibular space and normal thyroid gland was not seen in its anterior pretracheal location. On CT, a well-defined heterogeneous lesion (measuring 3.6 × 2.5 cm) was seen in the submandibular space in the midline. The lesion had nonenhancing cystic areas within. We confirmed absent eutopic thyroid gland on lower CT images.

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