Clinical and morphological characteristics of ectopic thyroid gland in children: A series of 24 patients from Northwest India

Background
Most adults with ectopic thyroid gland (ETG) are asymptomatic at the time of detection of ETG. Unlike adults, the clinical and morphological spectrum of ETG in children remains less characterized.

Methods
We retrospectively analyzed data of children with primary congenital hypothyroidism (CH) due to ETG who attended the pediatric endocrinology clinic of our hospital between April 2004 and March 2016. The diagnosis of ETG was based on combined scanning with technetium-99m (99mTc) pertechnetate thy¬roid scintigraphy and high-resolution thyroid ultrasonography.

Results
Twenty-four (18.7%) of the 128 children with primary CH were identified to have ETG. Their mean age at diagnosis was 64.3 ± 47 months (range, 0.5–144 months); 17 (70.8%) were girls. The mode of diagnosis was based on symptoms in 20, newborn screening in 3 and incidental in 1. Symptoms included poor weight gain in 13 (54%) developmental delay in 9 (37.5%), constipation in 8 (33%), decreased activity in 6, excessive sleepiness in 5, anorexia in 1 and decreased sweating in 1. The anatomical location of ETG was lingual in 17 (71%) and sublingual in 5 (21%). Thyroid function tests showed overt hypothyroidism in 16 and subclinical in 8. The mean duration of follow up was 16 ± 27.5 months (range 0.5–114 months).

Conclusion
We found symptomatic hypothyroidism to be common at presen-tation in our children with ETG. This is the largest series of children with ETG based on the diagnosis by combined scanning.