- 期刊
舌甲狀腺併下颌部異位性甲狀腺－病例報告
Lingual Thyroid Accompanied by a Submandibular Ectopic Thyroid - Case Report
摘要
舌甲狀腺（lingual thyroid）是位於舌根盲孔附近的甲狀腺組織。通常為單一病灶，多發性極罕見。臨床上大多發生於20歲左右的女性。大多數都沒有明顯的症狀，少部份會有喉嚨不適或吞嚥困難的情形。若病人有甲狀腺機能異常或出現明顯的症狀時就必須接受治療。本病例為一27歲女性，主訴長期喉嚨不適並且伴隨著異物感。理學檢查發現舌根中央部位有一個大小約2x2cm的鮮紅色腫塊。病灶經放射性同位素掃描（I131）發現舌根及右側下颌下位置出現一清楚的顯影，但前下頸部並未出現應有的甲狀腺顯影。病患經給予每天100mcg的甲狀腺素治療後病況已獲得改善。下颌下位置的異位性甲狀腺病例極罕見，英文文獻迄今僅有2例報告。發現舌根部或下颌下的不明腫塊時，應將異位性甲狀腺列入鑑別診斷，不可冒然施行切片檢查或手術摘除，以避免大量出血或甲狀腺功能低下等併發症。
並列摘要
Lingual thyroid is ectopic thyroid tissue located near the foramen cecum area of the tongue base. It usually appears as a single lesion, rarely as multiple foci. We report a case of lingual thyroid with the initial presentation of a lump sensation in the throat for over 6 months. The patient was a 27 year old woman and a reddish mass was found on her tongue base. Imaging studies and Iodine 131 thyroid uptake and scan proved the lesion to be a lingual thyroid. Associated ectopic thyroid tissue was located within the right submandibular area, an exceedingly rare combination. Mild hypothyroidism was found initially. She responded well to thyroxin replacement therapy(100 mcg/day)and her symptoms improved after treatment. Only 2 cases of submandibular ectopic thyroid tissue have been reported in the literature. Ectopic thyroid should be considered for any tongue base or submandibular lesion. As it may be the only functioning thyroid tissue, inappropriate or accidental surgical intervention will result in unnecessary complica-tions.