A new lateral neck mass in a 63-year-old man with multinodular goiter.

Described is a rare presentation of ectopic thyroid tissue as a lateral neck mass. This case raises the awareness that a lateral neck mass (including ectopic thyroid mass) needs appropriate investigations to rule out malignancy.

CLINICAL VIGNETTE

A 63‐year‐old male with a history of multinodular goiter (MNG) presented with a right lateral neck mass. Neck ultrasound confirmed MNG (4.6‐cm right midlobe nodule and 2.2‐cm left lower lobe nodule) and a 1.8‐cm level V right cervical mass (Figure 1). A Technetium99 thyroid scan was consistent with MNG with no uptake in the lateral neck mass. Fine‐needle biopsy showed: follicular lesion of unknown significance with negative ThyroseqTM (right 4.6‐cm nodule), benign left thyroid nodule and neck mass (Figure 2). Patient underwent right hemi‐thyroidectomy and resection of the lateral neck mass. Pathology confirmed MNG in the right lobe and benign thyroid tissue in the neck mass.

FIGURE 1

Ultrasound of the lateral neck mass

FIGURE 2

Cytology (fine‐needle biopsy of the neck mass)

The ectopic thyroid tissue (ETT) refers to any thyroid tissue found outside of the normal thyroid gland with the prevalence of 1 in 8000 patients with preexisting thyroid disorder. ETT is usually located along the midline and rarely found laterally. Therefore, whenever an ETT is detected in aberrant places, there is more likelihood of malignancy. The preoperative diagnostic tests include ultrasound and FNA cytology. In the case of the MNG along with ectopic tissue, thyroidectomy and excision of the ETT can be a satisfactory treatment.

CONFLICT OF INTEREST

None declared.

AUTHOR CONTRIBUTIONS

Nguyen T. Nguyen, MD – Author; Daniel Neelon, MD ‐ pathologist, reviewed the cytology slides; Michael I. Orestes, MD – otolaryngologist, reviewer; Mohamed KM Shakir, MD – reviewer; Thanh D. Hoang, DO – reviewer, corresponding author.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

ETHICAL APPROVAL

The manuscript has been reviewed and approved by the IRB and Public Affairs Office.