By Gary M. White, MD

Lingual thyroid Courtesy O. Dale Collins, MD

Lingual thyroid (LT) is a rare embryological anomaly caused by failure of the thyroid gland to descend from the foramen cecum to its normal site in the pre-laryngeal area. Thyroid tissue may be found anywhere along the course of the thyroglossal duct (i.e., oropharynx infrahyoid area, trachea, mediastinum, esophagus, and cervical lymph nodes). Among these, LT is the most common.


A midline posterior smooth nodule of the tongue with overlying blood vessels is characteristic. A thyroid scan, not a biopsy, is diagnostic.


There is no risk unless it enlarges secondary to cancer or goiter. One can try to reduce its size with thyroid medication. Surgery may be necessary, especially if there is bleeding or airway obstruction.


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