A case of hemiagenesis of thyroid with double ectopic thyroid tissue
An 18-year-old male presented with gradual onset swelling in front of the neck for 4 years. It was painless and was not associated with dysphagia, dysphonia, or dyspnea. There was no history of tremors, palpitations, or change in weight or bowel habits. There was no history of neck surgery or irradiation. Clinical examination of the neck revealed a soft swelling in the region of the left lobe of thyroid which moved freely with deglutition. There was no cervical lymphadenopathy and no eye or skin changes suggestive of autoimmune thyroid disease. Systemic examination was normal with no dextrocardia. Investigations revealed the following: (i) Thyroid function test was suggestive of subclinical hypothyroidism [free T4 1.1 ng/ml (normal 0.8-1.7), TSH 8.8 mIU/L (normal 0.4-4.2)]; (ii) antithyroperoxidase antibody was negative; (iii) ultrasound neck showed absent isthmus and right lobe with normal echogenecity and vascularity of the left lobe suggestive of hemiagenesis of thyroid; and (iv) technetium uptake nuclear scan of the thyroid gland revealed hemiagenesis of right lobe of the thyroid gland and also showed uptake in the suprahyoid and infrahyoid position suggestive of double ectopic thyroid gland [].