ESPE Abstracts

Background: Dystopia thyroid is an anomaly of development and is the result of a violation of embryogenesis and often remains unrecognized, the true frequency of the dystopia of the thyroid gland is not known, described 800 cases of ectopic thyroid gland in the region of blind holes of the tongue in adults and 80 cases in children, half of them diagnosed congenital hypothyroidism.

Objective and hypotheses: To reveal some features in the diagnosis and treatment of the ectopic thyroid in children.

Methods: A female child of 9 years with the nodal goiter in the family history was under observation. Physical development, ultrasound investigation data (UID) and standard laboratory tests – thyrotropic hormone (TTH), free thyroxin (T₄), thyroid peroxidase antibodies (a/b to TPO), were measured in the dynamics of observation.

Results: A dense reddish formation on a broad foot (3.0×4.5×3.0 in size), well vascularized, located anterior from vallecula, without fur has been found in the base of the tongue. Complaints: difficulty in swallowing solid food, pallor and dry skin, deep voice, bradycardia, tendency to constipation. Ultrasound investigation has established some changes in the thyroid ehostructure, its small size – 2.3 cm³ (normal size 4.5–6.8 cm³). Measurements: TTH – 16.77 mIU/l (normal findings 0.5–3.5 mIU/l), free T₄ – 11.3 pmol/l (11–21 pmol/l norm), and antibodies to TPO 19.64 IU/ml (30 IU/l norm). Hypothyroidism has been diagnosed in the patient. Replacement therapy with thyroid hormones in a dose of 75 mg per day has been prescibed. After 6 months noted positive dynamics of goiter size – the formation of the tongue has decreased to 1.5×2×1.5 cm, the complaint disappeared. The girl grows and develops according to age, the dose of T₄ in the 3 years of observation is increased to 100 mg per day, TSH level of 1.5 mIU/ml.

Conclusion: Dystopic thyroid gland diagnosed in prepubertal girls, which was accompanied by an increase in the size of goiter and hypothyroidism. The treatment with thyroxine size of the crop of the tongue decreased.