Lingual and Mediastinal Ectopic Thyroid with No Normal Thyroid Gland – A Very Rare Occurrence

Introduction Ectopic thyroid is a  rare  congenital  condition.  Dual ectopic  thyroid  is  rarer still with  only  30  cases  reported  in  literature.  The  most  common  location  is  the  lingual  or  sublingual  region  followed  by  the  hyoid  region.  Instances  of  dual  ectopic  thyroid  with  one  in  lingual  region  and  the  other  in  mediastinum  are very few. Case  Report A  case  of  dual  ectopic  thyroid is presented with  absent  normal  thyroid  in  a  girl  of  14  years  who  presented  with  difficulty  in  swallowing  and  lump  sensation  in  throat.  Ultrasound,  MRI  scan  and  Technetium  99m  pertechnetate  thyroid  scan  were  done.  She  showed  lingual  thyroid  and  thyroid  tissue  in  upper  mediastinum  and  no  thyroid  tissue  in  the  normal  anatomical  location.  Discussion The  discovery  of  mediastinal  ectopic  thyroid  was  incidental.  She  had  subclinical  hypothyroidism  and  was  treated  with  thyroxine  replacement  therapy

Lingual and Mediastinal Ectopic Thyroid with No Normal Thyroid Gland – A Very Rare Occurrence

Introduction Ectopic thyroid is a  rare  congenital  condition.  Dual ectopic  thyroid  is  rarer still with  only  30  cases  reported  in  literature.  The  most  common  location  is  the  lingual  or  sublingual  region  followed  by  the  hyoid  region.  Instances  of  dual  ectopic  thyroid  with  one  in  lingual  region  and  the  other  in  mediastinum  are very few. Case  Report A  case  of  dual  ectopic  thyroid is presented with  absent  normal  thyroid  in  a  girl  of  14  years  who  presented  with  difficulty  in  swallowing  and  lump  sensation  in  throat.  Ultrasound,  MRI  scan  and  Technetium  99m  pertechnetate  thyroid  scan  were  done.  She  showed  lingual  thyroid  and  thyroid  tissue  in  upper  mediastinum  and  no  thyroid  tissue  in  the  normal  anatomical  location.  Discussion The  discovery  of  mediastinal  ectopic  thyroid  was  incidental.  She  had  subclinical  hypothyroidism  and  was  treated  with  thyroxine  replacement  therapy

Intralesional Sclerotherapy with Polidocanol in the Management of Head and Neck Vascular Lesions

Introduction Vascular lesions (Hemangioma or vascular malformation) in the head and neck region are quite common and need therapeutic intervention if they become symptomatic or cosmetically unacceptable. Different therapeutic modalities including cryotherapy, corticosteroids, laser therapy, sclerotherapy, surgery and/or embolization are available. Advances in laser surgery as well as sclerotherapy techniques have improved our ability to treat extensive lesions. Surgical excision sometimes becomes very difficult due to massive per-operative bleeding and proximity to major neurovascular structures. In this study we have tried to find a simpler, easily available, safe and cost-effective therapy to treat these vascular lesions. Materials and Method         A pilot case study was conducted in a tertiary care hospital in Kolkata for a period of one year. Polidocanol was selected as the sclerosing agent for treatment of head and neck vascular lesions for its safety and its local anesthetic effect. 3% Polidocanol was injected in 20 lesions. Result 20 patients with head and neck vascular lesions treated with polidocanol sclerotherapy were followed up for 12 months. The study included 20 patients (12 female and 8 male) with mean age 20.3 years (range 6-62 years). Of these 20 patients 14 had 90% to 100% result and in 6 patients we obtained only mild improvement. Discussion Sclerotherapy is now becoming the first choice of treatment in head and neck vascular lesions. Polidocanol is a mixture of 5% ethyl alcohol and 95% hydroxypolyethoxydodecane, the detergent action of which induces a rapid overhydration of endothelial cells, leading to vascular injury and regression of vascular lesions. As the same time it is a local anesthetic, so treatment is painless. Conclusion It is a less invasive, cost effective, painless OPD based management for head and neck vascular lesions having good functional and aesthetic outcome