Single photon emission tomography in detection of the lingual thyroid ectopy. Its use in newborn with the congenital hypothyroidism – case report
Authors:
J. Doležal 1; D. Neumann 2
Authors place of work:
Oddělení nukleární medicíny FN, Hradec Králové
vedoucí doc. MUDr. J. Doležal, Ph. D.
1; Dětská klinika LF UK a FN, Hradec Králové
přednosta prof. MUDr. M. Bayer, CSc.
2
Published in the journal:
Čes-slov Pediat 2015; 70 (3): 179-182.
Category:
Reviews
Summary
Aim:
To present the importance of planar scintigraphy with 99mTc-pertechnetate sodium with single photon emission tomography (SPECT) in the diagnotics of ectopic thyroid.
Material and method:
We examined a newborn girl with congenital hypothyroidism (CH), which does not show a thyroid parenchyma in the usual location of the neck by ultrasound. Planar whole-body scintigraphy using front and lateral projections and static scintigrams of the head, neck and mediastinum with 99mTc-pertechnetate sodium (25 MBq intravenously), completed by SPECT detected a suspicious non-physiological uptake of the tracer, which was identified in the oral cavity. The examination was performed at previously initiated L-thyroxine treatment.
Results:
SPECT of the head, neck and chest revealed the presence of ectopic thyroid tissue in the root of the tongue.
Conclusion:
Scintigraphy with 99mTc-pertechnetate with variable addition of SPECT is essential to diagnose thyroid ectopia. Both complete an ultrasound imaging in neonates with CH, as ultrasound is not of enough value to diagnose the thyroid gland if it is not present in normal localization or do not display clear characteristics of thyroid tissue. Scntigraphy is also helpful for cases of suspected dyshormonogenesis and correct etiological diagnosis of certain types of hypothyroidism later in life.
Key words:
SPECT, hypothyroidism, lingual thyroid, newborn D.
Zdroje
1. Lucas-Herald A, Jones J, Attaie M, et al. Diagnostic and predictive value of ultrasound and isotope thyroid scanning, alone and in combination, in infants referred with thyroid-stimulating hormone elevation on newborn screening. J Pediatr 2014; 164 (4): 846–854.
2. Rahbar R, Yoon MJ, Connolly LP, et al. Lingual thyroid in children: a rare clinical entity. Laryngoscope 2008; 118 (7): 1174–1179.
3. Olivieri A, Stazi MA, Mastroiacovo P, et al. A population-based study on the frequency of additional congenital malformations in infants with congenital hypothyroidism: data from the Italian registry for congenital hypothyroidism (1991-1998). J Clin Endocrinol Metab 2002; 87 (2): 557–562.
4. Majumdar I, Mastrandrea LD. Lingual thyroid as a cause of primary hypothyroidism: congenital hypothyroidism in the neonatal period and beyond. Clin Pediatr 2010; 49 (9): 885–888.
5. Chanin LR, Greenberg LM. Pediatric upper airway obstruction due to ectopic thyroid: classification and case reports. Laryngoscope 1988; 98 (4): 422–427.
6. Porqueddu M, Antona C, Polvani G, et al. Ectopic thyroid tissue in the ventricular outflow tract: embryologic implications. Cardiology 1995; 86 (6): 524–526.
7. Clerc J, Monpeyssen H, Chevalier A, et al. Scintigraphic imaging of paediatric thyroid dysfunction. Hormone Res 2008; 70 (1): 1–13.
8. Büyükgebiz A. Newborn screening for congenital hypothyroidism. J Clin Res Pediatr Endocrinol 2013; 5 (Suppl 1): 8–12.
9. Hníková O, Vinohradská H, Dejmek P, Al Taji E. Dlouhodobé zkušenosti z monitorování jódového zásobení novorozenecké populace v České republice. Čes-slov Pediat 2014; 69 (4): 228–233.
10. Léger J, Olivieri A, Donaldson MDC, et al., on behalf of ESPE-PES--SLEP-JSPE-APEG-APPES-ISPAE, and the Congenital Hypothyroidism Consensus Conference Group. European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism. J Clin Endocrinol Metab 2014; 99 (2): 363–384.
11. Jones JH, Attaie M, Maroo S, et al. Heterogeneous tissue in the thyroid fossa on ultrasound in infants with proven thyroid ectopia on isotope scan – a diagnostic trap. Pediatr Radiol 2010; 40 (5): 725–731
12. Koranda P, Kabíčková E, Bělohlávek O, et al. Vyšetřovací metody nukleární medicíny v pediatrii. Pediatr pro Praxi 2005; 6 (6): 310–313.
13. Hušák V, Petrová K, Masopust J, Mysliveček M. Aplikované aktivity radiofarmak, radiační zátěž a radiační riziko vyšetřovacích postupů v nukleární medicíně. Čas Lék čes 1999; 138 (11): 323–328.
14. Brindhaban A, Eze CU. Estimation of radiation dose dutiny diagnostic x-ray examinations of newborn rabies and 1-year-old infants. Med Princ Pract 2006; 15 (4): 260–265.
15. Aktolun C, Demir H, Berk F. Complete ligual ectopia of the thyroid in a hypothyroid child. Thyroid 2001; 11 (11): 1081.
16. Moaddab MH, Siavash M. Lingual thyroid. N Engl J Med 2008; 358 (16): 1712.
17. Dutta D, Kumar M, Thukral A, et al. Medical management of thyroid ectopia: report of three cases. J Clin Res Pediatr Endocrinol 2013; 5 (3): 212–215.
18. Neves M, Azevedo P, Rodrigues M. Lingual thyroid: an accidental finding. Acta Otorinolaryngol Esp 2010; 61 (1): 87–88.
19. Dong R, Li K, Liu G, Zheng S. Dual ectopic thyroid with lingual and anterior hyoid ectopic tissue in a Chinese girl. Saudi Med J 2012; 33 (10): 1125–1127.
20. Perry RJ, Maroo S, Maclennan AC, et al. Combined ultrasound and isotope scanning is more informative in the diagnosis of congenital hypothyroidism than single scanning. Arch Dis Child 2006; 91 (12): 972–976.
21. Bubuteishvili L, Garel C, Czernichow P, Léger J. Thyroid abnormalities by ultrasonography in neonates with congenital hypothyroidism. J Pediatr 2003; 143 (6): 759–764.
22. De Silva A, Jong I, McLean G, et al. The role of scintigraphy and ultrasound in the imaging of neonatal hypothyroidism: 5-year retrospective review of single-centre experience. J Med Imaging Radiat Oncol 2014; 58 (4): 422–430.
Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
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