Lingual Thyroid

Aka: Lingual Thyroid, Sublingual Thyroid Gland

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II. Epidemiology

  1. Most common ectopic Thyroid tissue (but rare overall)

III. Pathophysiology

  1. Failed developmental descent of Thyroid tissue
    1. Ectopic Thyroid located at the base of the Tongue (thyroglossal duct remnant)
  2. Lingual Thyroid is often insufficient alone to provide adequate systemic Thyroid Hormone
    1. More than 70% have no additional Thyroid tissue in the normal anatomic position
    2. Hypothyroidism risk
  3. Lingual Tonsil may hypertrophy with certain conditions
    1. Upper Respiratory Infection
    2. Pregnancy
    3. Puberty

IV. Symptoms

  1. Often asymptomatic
  2. Hypertrophied lingual Tonsils may become symptomatic
    1. Dysphagia
    2. Dysphonia
    3. Dyspnea

V. Signs

  1. Round, smooth, red mass, non-tender at posterior midline Tongue base

VI. Differential Diagnosis

  1. See Tongue Mass
  2. See Adult Neck Mass
  3. Thyroglossal Cyst

VII. Management

  1. Asymptomtic cases require no specific management (outside of evaluating Thyroid function)
  2. Symptomatic hypertrophy of the lingual Tonsil
    1. Thyroid Hormone Replacement may decrease Thyroid size
    2. Lingual Thyroid excision is typically avoided outside of airway obstruction
      1. Risk of severe Hypothyroidism

VIII. Complications

  1. Hypothyroidism
  2. Hyperthyroidism
  3. Lingual Thyroid Carcinoma is rare

IX. References

  1. Straub (2024) Am Fam Physician 110(5): 467-75 [PubMed]
  2. Cruz-Dardíz (2020) Endocrinol Diabetes Metab Case Rep +PMID: 32478670 [PubMed]

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