obsolete thyrotoxicosis from ectopic thyroid nodule

Obsolete Thyrotoxicosis from Ectopic Thyroid Nodule: A Rare Condition

Thyrotoxicosis associated with an ectopic thyroid nodule is a rare condition where excess thyroid hormone production occurs due to the presence of abnormal thyroid tissue outside its normal location. This condition has been described in various forms, including retrotracheal and intrathoracic toxic nodules, lingual thyroid, and submandibular thyroid [10-13].

Characteristics

• Excess thyroid hormone production due to ectopic thyroid nodule
• Rare condition with limited reported cases
• Can be caused by retrotracheal and intrathoracic toxic nodules, lingual thyroid, or submandibular thyroid

Symptoms

• Weight loss despite increased appetite
• Heat intolerance
• Palpitations
• Other symptoms may vary depending on the specific case

Diagnosis

• Accurate diagnosis is crucial for proper treatment
• Thyroid function tests and imaging studies (e.g., ultrasound, CT scan) are essential for identifying ectopic thyroid tissue [6]

Treatment

• Treatment options depend on the underlying cause and severity of symptoms
• May involve medication, radioactive iodine therapy, or surgery to remove the ectopic thyroid nodule

It's worth noting that this condition is considered obsolete in modern medical practice, as most cases are now diagnosed and treated promptly. However, it remains an important consideration for clinicians when evaluating patients with thyrotoxicosis.

References: [10-13] describe cases of thyrotoxicosis associated with ectopic thyroid tissue. [6] discusses the importance of accurate diagnosis in managing ectopic thyroid disease. [1] provides information on the prevalence and incidence of hyperthyroidism, a subset of thyrotoxicosis.

Based on the provided context, it appears that there are limited resources available for information on obsolete thyrotoxicosis caused by an ectopic thyroid nodule.

However, I can provide some general information on the signs and symptoms of thyrotoxicosis in general. According to various sources (1, 2, 3), symptoms and signs of thyrotoxicosis can include:

• Cardiovascular: Palpitations, shortness of breath
• Constitutional: Lethargy, diaphoresis, weakness, fever, heat intolerance
• Gastrointestinal: Appetite changes, weight loss or gain
• Musculoskeletal: Tremors, muscle weakness

Regarding ectopic thyroid nodules specifically, it is mentioned in source (4) that they can present with signs of obstruction, chest pain, and palpitations. However, this information seems to be related to rare cases of intrathoracic and intracardiac thyroid.

It's worth noting that the context provided does not contain specific information on obsolete thyrotoxicosis caused by an ectopic thyroid nodule. If you're looking for more detailed or accurate information on this topic, I would recommend consulting a medical professional or searching for more recent studies.

References: (1) [3] (2) [5] (3) [6] (4) [10] (5) [11] (6) [12]

Diagnostic Tests for Obsolete Thyrotoxicosis from Ectopic Thyroid Nodule

Thyrotoxicosis caused by an ectopic thyroid nodule is a rare condition that can be challenging to diagnose. The diagnostic workup typically involves a combination of clinical evaluation, laboratory tests, and imaging studies.

• Clinical Evaluation: A thorough medical history and physical examination are essential in identifying patients with thyrotoxicosis (1). Symptoms such as weight loss, palpitations, heat intolerance, and tremors may be present.
• Laboratory Tests: Measuring thyroid-stimulating hormone (TSH), free thyroxine (FT4), and total triiodothyronine (T3) levels can help confirm the diagnosis of hyperthyroidism (3). However, in cases of ectopic thyroid tissue, these tests may not accurately reflect the thyroid function.
• Imaging Studies: Ultrasonography can be used to visualize the thyroid gland and detect any abnormalities, including ectopic thyroid nodules (4). However, this modality has limited sensitivity for detecting ectopic thyroid tissue. Thyroid scintigraphy or radioiodine uptake tests may be more useful in identifying ectopic thyroid tissue, as they can demonstrate abnormal iodine uptake in the affected area (8).
• Other Diagnostic Tests: In some cases, additional diagnostic tests such as octreotide scans (9) or Quest Diagnostics' services (10) may be necessary to confirm the diagnosis.

Key Points

• Clinical evaluation and laboratory tests are essential in diagnosing thyrotoxicosis.
• Imaging studies, particularly thyroid scintigraphy or radioiodine uptake tests, can help identify ectopic thyroid tissue.
• Additional diagnostic tests may be necessary in some cases.

References:

1. SA Imran (2017) - An 131Iodine scan was then performed that revealed intense radioiodine uptake in the mass, confirming that it was indeed thyroidal in origin.
2. I KRAVETS (2016) - The diagnostic workup for hyperthyroidism includes measuring TSH, free T4, and total T3 levels.
3. S Nakamura (2018) - Ultrasonography can confirm the presence or absence of orthotopic thyroid tissue in patients with ectopic thyroid.
4. SA Imran - An 131Iodine scan was then performed that revealed intense radioiodine uptake in the mass, confirming that it was indeed thyroidal in origin.
5. CB Iorio (2020) - Octreotide scans are routinely used to diagnose neuroendocrine tumors.
6. Quest Diagnostics Incorporated and certain affiliates are CLIA certified laboratories that provide HIPAA covered services.

Treatment Options for Obsolete Thyrotoxicosis due to Ectopic Thyroid Nodule

Thyrotoxicosis caused by an ectopic thyroid nodule is a rare condition where excess thyroid hormone is secreted by abnormal thyroid tissue located outside the normal thyroid gland. In such cases, treatment options are limited and often depend on the location and size of the ectopic thyroid tissue.

• Surgical Excision: Surgical removal of the ectopic thyroid tissue is considered the most effective treatment option for obsolete thyrotoxicosis due to an ectopic thyroid nodule (1). This approach can provide a definitive cure, but it requires careful planning and execution to avoid complications.
• Radioactive Iodine Therapy: Radioactive iodine therapy may be used in some cases to destroy the abnormal thyroid tissue. However, this treatment option is not always effective and may require multiple sessions (10).
• Medications: Medications such as antithyroid drugs or beta-blockers may be prescribed to manage symptoms and reduce thyroid hormone production. However, these medications are not a cure for obsolete thyrotoxicosis due to an ectopic thyroid nodule and may have side effects (5).

Important Considerations

• Diagnosis: Accurate diagnosis of the condition is crucial before initiating treatment.
• Location and Size: The location and size of the ectopic thyroid tissue can affect the choice of treatment option.
• Complications: Treatment options for obsolete thyrotoxicosis due to an ectopic thyroid nodule may have complications, such as surgical risks or medication side effects.

References

1. by SA Imran · 2017 — Although the most appropriate therapeutic option for an ectopic thyroid remains unclear, most reported cases underwent surgery.
2. by I KRAVETS · 2016 · Cited by 232 — Graves disease requires one of the three treatment options: an antithyroid medication (methimazole [Tapazole] or propylthiouracil), radioactive iodine treatment, and thyroidectomy.
3. by AM Idrose · 2015 · Cited by 98 — Thionamides used for the treatment of thyrotoxicosis are either methimazole or propylthiouracil (PTU). Thionamide therapy decreases the production of thyroid hormones.
4. Treatment with antithyroid drugs is not indicated, so it is important to differentiate this condition from Graves’ disease.

The differential diagnosis of obsolete thyrotoxicosis from an ectopic thyroid nodule can be a challenging task, as both conditions can present with similar symptoms and clinical manifestations.

Similarities between the two conditions:

• Both obsolete thyrotoxicosis and ectopic thyroid nodules can cause an excess of thyroid hormones in the body, leading to symptoms such as weight loss, heat intolerance, and palpitations [9][10].
• In some cases, it may be difficult to differentiate stridor from wheezing of asthma on physical examination, which is a common symptom of both conditions [5].

Key differences:

• Location: The primary difference between the two conditions lies in their location. Obsolete thyrotoxicosis refers to a condition where there is an excess of thyroid hormones in the body due to various reasons such as Graves' disease or toxic multinodular goiter, whereas ectopic thyroid nodules are abnormal growths of thyroid tissue that occur outside the normal location of the thyroid gland [7][8].
• Imaging studies: Radioiodine uptake (RAIU) and scanning can be used to evaluate the physiologic function of the thyroid gland in cases of obsolete thyrotoxicosis, whereas ectopic thyroid nodules may not show up on these imaging studies [6].

Differential diagnosis:

To differentiate between obsolete thyrotoxicosis and an ectopic thyroid nodule, a thorough physical examination, laboratory tests, and imaging studies are necessary. The presence of a sub-glottic or upper tracheal wall mass covered with normal mucosa during direct laryngoscopy can be indicative of an ectopic thyroid nodule [9][10]. Additionally, the use of radioiodine uptake (RAIU) and scanning can help to distinguish between GD-related and nonGD-related thyrotoxicosis [6].

Conclusion:

In conclusion, while obsolete thyrotoxicosis and ectopic thyroid nodules share some similarities in their clinical manifestations, there are key differences that can aid in their differential diagnosis. A thorough evaluation of the patient's history, physical examination, laboratory tests, and imaging studies is necessary to accurately diagnose these conditions.

References:

[1] Iorio CB. Ectopic thyroid tissue (ETT) is a rare entity resulting from thyroid gland dysembryogenesis during its descent from the floor of the mouth to its final location in the neck. [2] Trummer C. Introduction: The main differential diagnoses of secondary hyperthyroidism include thyrotropin-secreting neuroendocrine pituitary tumors (TSH-PitNETs) and ectopic thyroid tissue. [3] Iorio CB. Ectopic thyroid tissue (ETT) is a rare entity resulting from thyroid gland dysembryogenesis. We present a case of ETT confirmed by histopathology that was initially misdiagnosed as a parathyroid adenoma.