TANI AMAÇLI UYGULANAN İYOT-131 İLE ABLATE OLAN EKTOPİK TİROİD DOKUSU: OLGU SUNUMU
TANI AMAÇLI UYGULANAN İYOT-131 İLE ABLATE OLAN EKTOPİK TİROİD DOKUSU: OLGU SUNUMU
Yazar: Usluoğulları, Celil; Balkan, Fevzi; Özdemir, Elif; Poyraz, Nilüfer; Sağlam, Fatma; Doğanay, Şahin; Ersoy, Reyhan; Çakır, Bekir
Dergi: Bozok Tıp Dergisi, Vol. 4 No. 3, 2014
Anahtar kelimeler: Ectopic thyroid; Lingual thyroid; Iodine 131 ; Ektopik tiroid; Lingual tiroid; İyot 131

ÖZETOtopsi çalışmalarında ektopik tiroid dokusu varlığı %10 oranında bildirilmiştir. Asemptomatik kişilerde ektopik tiroid dokusunun önemi bilinmemektedir. Bununla birlikte ektopik tiroid dokusunun tiroid kan- seri için artmış risk oluşturduğuna dair raporlar literatürde mevcuttur. İyot-131 ektopik tiroid dokusu araştırılmasında kullanılmaktadır. Tarama sintigrafisi düşük doz (2-5 mCi) ile yapılır. Tiroid bezinin gramı başına yaklaşık 6 MBq (160 µCi) verilen İyot-131 ise ablasyon dozudur. Bu bildiride 14 yıl önce Toksik Diffüz Guatr (TDG) tanısı ile bilateral subtotal tiroidektomi uygulanan 42 yaşındaki kadın hastaya nüks toksik diffüz nodüler guatr tanısı ile tamamlayıcı tiroidektomi uygulanmıştı. Hastanın operasyon sonrası altıncı ay kontrolünde orta hatta, hyoid kemik hizasında, 12X24 mm boyutunda, ektopik tiroid dokusu mevcuttu. İİAB sonucu “önemi belirlenemeyen atipi” olarak raporlandı. İİAB sırasında hazırlanan yıkama örneklerinden bakılan tiroglobulin seviyesi >300 idi.. Bu nedenle malignite ve uzak metastaz varlığını değerlendirmek amacı ile 3 mCi İyot-131 ile tüm vücut tarama yapıldı ve sadece boyunda star artefakta neden olan aktivite birikimi izlendi.. Sitolojik bulgular nedeni ile üç ay sonra yapılan boyun USG’de ise ektopik tiroid dokusu izlenmiyordu. L-Tiroksin tedavisi kesildikten sonra çekilen tiroid sintigrafisinde de ektopik tiroid dokusunu düşündürecek bulguya rastlanmadı. İyot-131 uygulaması sonrası dokunun ab- late olduğu kararına varıldı. Olgu ektopik tiroid dokusunun nadir görülmesi ve ilginç klinik seyri nedeni ile sunulmuştur.Anahtar kelimeler: Ektopik tiroid; Lingual tiroid; İyot 131ABSTRACTThe presence of ectopic thyroid tissue has been reported at a rate of 10% in autopsy studies. The significance of ectopic thyroid tissue among asymptomatic individuals is unknown. However, there are reports in literature suggesting an increased risk of thyroid cancer in the presence of ectopic thyroid tissue. Iodine-131 is used for detecting ectopic thyroid tissue. Screening scintigraphy is performed using low doses (2-5 mCi). Iodine-131 given for ablative purposes is approximately 6 MBq (160 µCi) per gram of thyroid gland. In this report 42-year-old woman who underwent bilateral subtotal thyroidectomy 14 years ago, with a diagnosis of diffuse toxic goiter was performed completion thyroidectomy with a diagnosis of recurrent nodular diffuse toxic goiter. At six months after the operation, midline, at the level of the hyoid bone, 12X24 mm in size, ectopic thyroid tissue was present in patient. “Atypia of undetermined significance” was reported in FNA results. The thyroglobulin level was 300 in washing samples drawn up during FNA. In order to evaluate the presence of malignancy and metastasis, whole- body scan with 3 mCi of iodine-131 was performed and only the activity accumulation leads to star artifact was observed in the neck. Ectopic thyroid tissue was not observed in the neck ultrasound performed after three months because of cytologic findings . There was no findings to suggest ectopic thyroid tissue in the thyroid scintigraphy after cessation treatment of L-thyroxine. It was concluded that thyroid tissue was ablated after application of iodine-131 treatment.Keywords: Ectopic thyroid; Lingual thyroid; Iodine 131

The presence of ectopic thyroid tissue has been reported at a rate of 10% in autopsy studies. The significance of ectopic thyroid tissue among asymptomatic individuals is unknown. However, there are reports in literature suggesting an increased risk of thyroid cancer in the presence of ectopic thyroid tissue. Iodine-131 is used for detecting ectopic thyroid tissue. Screening scintigraphy is performed using low doses (2-5 mCi). Iodine-131 given for ablative purposes is approximately 6 MBq (160 μCi) per gram of thyroid gland. In this report 42-year-old woman who underwent bilateral subtotal thyroidectomy 14 years ago, with a diagnosis of diffuse toxic goiter was performed completion thyroidectomy with a diagnosis of recurrent nodular diffuse toxic goiter. At six months after the operation, midline, at the level of the hyoid bone, 12X24 mm in size, ectopic thyroid tissue was present in patient. “Atypia of undetermined significance” was reported in FNA results. The thyroglobulin level was 300 in washing samples drawn up during FNA. In order to evaluate the presence of malignancy and metastasis, wholebody scan with 3 mCi of iodine-131 was performed and only the activity accumulation leads to star artifact was observed in the neck. Ectopic thyroid tissue was not observed in the neck ultrasound performed after three months because of cytologic findings . There was no findings to suggest ectopic thyroid tissue in the thyroid scintigraphy after cessation treatment of L-thyroxine. It was concluded that thyroid tissue was ablated after application of iodine-131 treatment.