Lingual thyroid: value of integrated imaging

Lingual thyroid is an uncommon cause of oropharyngeal mass, due to a congenital anomaly of thyroidal development and migration: It is defined precisely as the presence of thyroid tissue in the mid-line of the tongue base between circumvallatae papillae and the epiglottis. We report a case of lingual thyroid in which the integration of clinical data, sonography, color-duplex Doppler, MRI and scintigraphy was determinant in demonstrating the disease. A 22-year-old woman presented with a sensation of foreign body in the throat, dysphonia, dyspnoea and dysphagia; we performed sonography (7.5 MHz linear probe), color Doppler (7 MHz Doppler frequency, PRF 3500 Hz) and MRI (1.5 T, spin-echo T1- and T2-weighted images with administration of Gd-DTPA); a scan with 123I demonstrated a relevant uptake at the base of the tongue, but no uptake at the typical thyroid location. The gland was removed and partially transplanted in the strap muscles of the neck.