The thyroid gland
Rogan J Corbridge in Essential ENT, 2011
The thyroid gland develops in the embryo at the base of the tongue. It descends through the tissues of the anterior neck and finally comes to rest overlying the trachea and larynx. The thyroid tissue is very vascular and consequently trauma to the thyroid can result in impressive bleeding into the neck. Bleeding into thyroid cysts is relatively common; this will lead to a rapid enlargement, which is often painful due to stretching of the capsule of the gland. Usually during examination of a normal neck, the thyroid gland will be neither seen nor felt. Thyroid surgery is usually performed by general or ENT surgeons. Histological examination of thyroid tissue shows the gland to be composed largely of follicles and supporting cells. In cases of hypothyroidism, thyroxine replacements are required on a daily basis; after thyroidectomy, treatment is mandatory for life. Some types of thyroid tumour trap iodine, and this ability can be determined via an isotope scan.
Imaging of the thyroid gland
Pallavi Iyer, Herbert Chen in Thyroid and Parathyroid Disorders in Children, 2020
Given the location of the thyroid gland and biology of thyroid hormone synthesis, several different radiologic modalities maybe used, including scintigraphy, computed tomography, and ultrasound. Technetium scan pertechnetate is a radio-isotope that mimics iodine and is used for thyroid imaging. It is administered via intravenous injection and is trapped in the thyrocyte via the sodium iodide symporter in the thyroid cell. Based on the anterior neck location, the thyroid gland can easily be viewed by a non-invasive method such as a thyroid ultrasound. Thyroid ultrasonography can detect and localize the thyroid gland and measure volume. The best use of thyroid ultrasound is to define thyroid nodules. If on physical exam, a thyroid nodule is palpated or a thyroid nodule is found incidentally on another imaging study, a thyroid ultrasound is recommended for further characterization of the nodule. Generally, computed tomography and magnetic resonance imaging are not required for characterization of the thyroid gland.
Thyroid and parathyroid
Harold Ellis, Sala Abdalla in A History of Surgery, 2018
Radical removal of the thyroid gland may damage the recurrent laryngeal nerve with consequent hoarseness, remove the parathyroid glands with resultant tetany or result in hypothyroidism if insufficient functioning thyroid tissue remains. Operating on the thyroid in a patient with advanced hyperthyroidism in the days before effective drugs were available to control the metabolic complications of the overactive gland was hazardous indeed. The thyroid gland was known to Galen, who thought it produced a fluid to lubricate the larynx. Enlargement of the thyroid gland produced such an obvious physical change in the neck that it has been observed since early times. One common cause of thyroid enlargement is iodine deficiency. In the 19th century, the mortality of thyroid surgery was over 40%, and many leading surgeons advised against the operation. Thyroidectomy was condemned by the French Academy of Medicine in 1850.
Incidence of thyroid gland invasion in advanced laryngeal cancers and its impact on disease-specific survival; a retrospective review at a tertiary care center
Published in Acta Oto-Laryngologica, 2020
Tahir Muhammad, Rahim Dhanani, Sameen Mohtasham, Muntazir Hussain, Muhammad Faisal, Kashif Iqbal Malik, Arif Jamshed, Raza Hussain
Background: Incidence of thyroid gland invasion in advanced laryngeal cancers is low. Ipsilateral or total thyroidectomy along with total laryngectomy has been controversial and there has been no consensus over the management of thyroid gland in advanced laryngeal cancers.Objective: To determine the frequency of thyroid gland invasion in locally advanced laryngeal squamous cell carcinoma and the risk factors associated with it.Material and methods: A retrospective review of patients with laryngeal squamous cell carcinoma operated at our center between January 2011 and December 2018 was carried out. Patients undergoing upfront or salvage laryngectomy with or without neck dissection along with hemi or total thyroidectomy were included. Histopathology reports were reviewed to record the involvement of thyroid gland.Results: Invasion of thyroid gland by squamous cell carcinoma larynx was seen in 10 (10.9%) patients out of 92. All of the cases showed direct extension of the tumor. Trans-glottic, subglottic, and tumors with extra laryngeal spread were found to be significantly associated with thyroid gland invasion. Patients with thyroid gland invasion showed higher rate recurrence.Conclusion and significance: Incidence of thyroid gland invasion in squamous cell carcinoma larynx is low, allowing us not to address thyroid routinely in patients undergoing total laryngectomy for laryngeal carcinoma.
Diffuse amyloid deposition in thyroid gland: a cause for concern in familial Mediterranean fever
Published in Amyloid, 2012
Özlem Turhan İyidir, Mustafa Altay, Ceyla Konca Degertekin, Alev Altınova, Ayhan Karakoç, Göksun Ayvaz, Metin Arslan, Kürşad Öneç, Turgay Arınsoy, Nesibe Cesur, İpek Işık Gönül
Thyroid gland is among the many organs that could be infiltrated in systemic amyloidosis. However, diffuse infiltration of the thyroid gland secondary to systemic amyloidosis associated with Familial Mediterranean fever (FMF) is rare. Here, we present a 49-year-old woman diagnosed with FMF and systemic amyloidosis, who had a large goiter and multiple nodules that developed slowly through the years and was complicated by tracheal compression symptoms and a mild thyroid dysfunction. Multiple fine needle aspiration biopsies of the nodules and the thyroid parenchyma revealed amyloid deposits. We would like to point out that amyloidosis may have a significant impact on the thyroid gland and fine needle aspiration biopsy is a valuable tool for diagnosis.
Glucocorticoid receptor subunit gene expression in thyroid gland and adenomas
Published in Acta Oncologica, 2006
Xiao-Wen Zhang, Yuan Li, Zhen-Lin Wang, Peng Li
The present study was undertaken to investigate whether the glucocorticoid receptor –α (GR-α) and –β (GR-β) mRNA may be expressed in thyroid gland. Ten normal thyroid gland and 14 follicular adenomas were studied using a real-time fluorescent quantitative RT-PCR (FQ-RT-PCR) method. The results demonstrated that there was a lower expression of GR-α mRNA (×106 GR-α cDNA copies/µg total RNA) in thyroid adenoma (1.27±0.26) than that in normal thyroid gland (3.53±1.22) (p