Dual ectopic thyroid in the presence of atrophic orthotopic thyroid gland in a patient with acquired hypothyroidism: Evaluation with hybrid Single-Photon Emission Computed Tomography/Computed Tomography
A 13-year-old boy presented with stunted growth and poor school performance. A thorough clinical history revealed that initial motor and social developments as a child were within limits. However, the boy was stunted. Local examination of the neck was unremarkable. His Thyroid-stimulating hormone (TSH) was >100 IU/ml. Thyroid antibodies was significantly elevated. His serum free T3 and free T4 were low. An ultrasonogram (USG) of the neck was performed which showed atrophic orthotopic thyroid gland.\nTechnetium thyroid scan [] was performed to evaluate the functional status of the orthotopic thyroid gland. Planar image anterior view (a) and face turned to the right (b) shows 2 foci of tracer uptake in the upper part of the neck. No tracer uptake was noted in the expected location of orthotopic thyroid gland. SPECT CT showed atrophic thyroid gland without any technetium uptake (c) and localized the ectopic thyroid tissues (ETT) to the sub-hyoid location (d) and suprahyoid locations (e). The patient is being managed with thyroxine replacement.