Ectopic lingual thyroid
A 12-year-old female patient with no family history, addressed to our department for investigation of a failure to thrive. In the personal history of this child, there is dysphagia to solids with high selective aspiration food lasting for 1 year (since 2001), which justified a consulting ear, nose and throat (ENT) in March 2002 and revealed a mass at the base of the tongue with a hormonal balance in favor of a biological hypothyroidism. No hormone replacement therapy was initiated and the patient admits that she never represented to consultation until February 2006, when she was sent to us for failure to thrive. On admission, she weighed 26.00 kg (-2SD), her height was 132 cm (-3SD), and pubertal development estimated at S1 P1 A1 (according to Tanner) without signs of thyroid dysfunction or dyspnea, dysphonia and dysphagia. The neck palpation was normal but examination of the back oral cavity showed a training round, sessile, smooth, red, and covered with some telangiectasia on the surface []. The hormonal assessment showed TSHus to 12 μIU/ml (0.25-3.1) and FT4-5.11 pmol/l (10-20) in favor of a peripheral hypothyroidism, the dosage of thyroid antibodies (thyroperoxidase antibody and thyroglobulin antibody) was normal as well as the thyroglobulin. Bone age was estimated at 8 years late compared to chronological age. The neck ultrasonography revealed a hypoechoic sublingual formation and revealed the presence of a small orthotopic thyroid parenchyma predominating on the left. Thyroid scan with technetium 99m (Tc-99 m) showed a selective uptake of radiotracer in sublingual position [].\nA cervical computed tomography (CT) was performed and showed a posterior median sublingual mass spontaneously hyperdense and enhancing sharply after injection of contrast [].\nThe diagnosis of hypothyroidism device in connection with a lingual thyroid is retained and the child received a hormone replacement therapy with thyroxine at a dose of 75 μg/d. After 5 months of treatment, the TSHus control was 1.75 μIU/ml signing the biological euthyroidism.