甲状腺外に生じた腺腫様甲状腺腫例

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  • A Case of Extrathyroidal Adenomatous Goiter
  • コウジョウセン ガイ ニ ショウジタ セン シュ ヨウ コウジョウセンシュレイ

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<p>Ectopic thyroid gland is uncommon, with a prevalence approximately of 1:100,000–300,000 persons. Ectopic thyroid gland in the anterior cervical region with coexisting normally located thyroid gland is rare.</p><p>We present the case of a 67-year-old man who presented with a painless palpable mass in the anterior cervical region. Thyroid function tests were normal, except for an elevated serum thyroglobulin (Tg) level (1,520 ng/ml). Neck ultrasonography and computed tomography (CT) showed a solid anterior cervical tumor measuring 18 mm in diameter, and a 37-mm goiter of the thyroid right lobe. Fine needle aspiration cytology (FNAC) of the anterior cervical tumor and goiter showed no malignant cells in either (class1-Bethesda System), but the Tg level in the aspiration needle washout fluid (NWF) of the anterior cervical tumor was markedly elevated (322,000 ng/ml). The CT revealed that the cervical mass was a separate structure from the thyroid. We suspected either occult lymph node metastasis from thyroid cancer or thyroglossal duct carcinoma, and performed tumor resection and thyroid right lobectomy. Histopathological examination showed ectopic adenomatous goiter and adenomatous goiter of the thyroid right lobe.</p><p>Ectopic thyroid gland with a coexisting normally located thyroid gland should be considered in the diagnosis of a cervical mass. It is necessary to consider the possibility of malignancy and also carefully consider the indication for surgical intervention. We present a criteria for surgery of an ectopic thyroid gland.</p><p>In this case, a long-term follow-up is needed, since tumor recurrence after surgery performed 20 years ago was suspected.</p>

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