Thyroid hemiagenesis and Hashimoto's thyroditis-diagnostic and treatment pitfalls

World J Surg Oncol. 2017 Oct 6;15(1):182. doi: 10.1186/s12957-017-1250-0.

Abstract

Background: Thyroid hemiagenesis (TH) is a rare congenital disease with absence of a thyroid lobe; most patients have no clinical symptoms. The etiology of TH remains unclear. In this paper, we describe a rare case of TH and congenital absence of the ipsilateral parathyroid gland, found during the operation, combined with the autoimmune disease Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis.

Case presentation: A 31-year-old woman was admitted to our hospital because of a mass in the right neck. Surgical exploration validated the absence of the left lobe of the thyroid and parathyroid glands, and pathological examination of the excised nodules confirmed Hashimoto's thyroiditis. Patients with TH might show accompanying absence of the ipsilateral parathyroid gland. The case described here, in which TH was combined with Hashimoto's thyroiditis, is rare in the medical literature. The operation should be ended at once if Hashimoto's thyroiditis is diagnosed during surgery.

Conclusions: Absence of thyroid lobe may accompany with a congenital absence of the ipsilateral parathyroid gland and Hashimoto's thyroiditis. Fine needle aspiration is essential to diagnosis and decision-making of the treatment.

Keywords: Hashimoto’s thyroiditis; Parathyroid gland; Thyroid hemiagenesis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Autoantibodies / blood
  • Biopsy, Fine-Needle
  • Clinical Decision-Making
  • Female
  • Hashimoto Disease / blood
  • Hashimoto Disease / diagnosis*
  • Hashimoto Disease / pathology
  • Hashimoto Disease / therapy
  • Humans
  • Incidental Findings*
  • Parathyroid Glands / abnormalities*
  • Parathyroid Glands / pathology
  • Parathyroid Glands / surgery
  • Thyroid Dysgenesis / diagnosis*
  • Thyroid Dysgenesis / pathology
  • Thyroid Dysgenesis / surgery
  • Thyroid Gland / abnormalities*
  • Thyroid Gland / pathology
  • Thyroid Gland / surgery
  • Thyroidectomy / adverse effects*
  • Thyroidectomy / methods
  • Thyroxine / therapeutic use
  • Tomography, Emission-Computed
  • Ultrasonography, Doppler, Color

Substances

  • Autoantibodies
  • Thyroxine