A 6-yrs-old child complains of difficulty in swallowing and on examination there is a sublingual swelling, which is suspected to be Lingual thyroid. The 1st step in management of this child would be:: (A) Tracheostomy and airway maintenance, (B) Thyroid scan, (C) Intubation, (D) Explain to child's parents that he may require immediate surgery
Answer is B. Lingual Thyroid It represents failure of median thyroid tissue to descend normally. Presentation * Asymptomatic * Choking, dysphagia * Airway obstruction, hemorrhage * Hypothyroidism (occasionally) Investigation. Thyroid scan- always performed before radioablative therapy or surgery as it may be the only thyroid tissue present. Treatment * Replacement thyroxine - decrease the size * Radioactive iodine - decrease the size * Surgery- excision rarely required.