45 year old lady presented with difficulty in swallowing. Oral examination revealed mass near base of tongue. Patient was referred for CT scan.

Image:

Axial CT image showed well-marginated hyperdense lesion near base of tongue. The lesion showed uniform enhancement following contrast.

The diagnosis was obvious on plain scan.

Diagnosis;

LINGUAL THYROID.

Discussion;

Lingual thyroid is the term applied to a mass of ectopic thyroid tissue located at the base of the tongue n midline. This developmental anomaly may occur anywhere along the thyroglossal tract due to failure of decent of thyroid tissue.

It may present with symptoms of dysphagia or upper airway obstruction.

Computed tomography provides an accurate method of determining gland tissue. However technetium scan helps to show activity at the level of lesion and no apparent activity in neck. Treatment of this disorder includes use of exogenous thyroid to correct hypothyroidism to induce shrinkage of gland. When symptoms of obstruction or bleeding appear, ablative therapy may be performed.