Anwar UI Haque, Mahanna M A, Latif A, Al Arfaj, Arzt Fur Chirugie, Dawalatly E E, Huda Ismail.
Synchronous Follicular Carcinoma of Thyroid Gland and Thyroglossal Duct Remnants in Hyoid Bone.
J Pak Inst Med Sci Jan ;14(1):750-3.

A 17-year-old Saudi lady presented to King Fahad Hospital, Al-Khobar with a swelling of the neck. She had a previous history of thyroid surgery 18 months previously in her remote seaside home village. All attempts to obtain the copies of previous operative and histopathological reports were unsuccessful. She had recently married and moved to Al-Khobar area. The history and clinical examination revealed a multinodular thyroid swelling. No signs or symptoms of thyroid toxicity were seen. There was a scar of a low collar incision. No palpable cervical lymph nodes or any evidence of distant systemic involvement was seen. On ultrasound examination the thyroid nodules appeared to be solid. Indirect larynogscopy uncovered a left vocal cord paralysis although the patient denied any voice change. Whether this was iatrogenic or congenital in origin, could not be ascertained. The isotope thyroid scan showed a 24 hour uptake of 17%. It also demonstrated evidence of partial thyroidectomy with non-homogenous distribution. There was no evidence of ectopic isotope uptake. The patient underwent exploration of the neck and subtotal thyroidectyomy. The histopathological findings were suspicious but not diagnostic of malignancy. The postoperative period was uneventful and the patient was discharged from the hospital with an appointment to be seen in the outpatient department. However she did not comply and instead presented two years later with an approximately 2 cm diameter painless, firm mass at the level of the hyoid bone. Continued ...

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