Introduction:Lingual thyroid is caused by a rare developmental disorder caused due to aberrantembryogenesis during the descent of thyroid gland to the neck. Lingual thyroid is themost frequent ectopic location of thyroid gland. Prevalence rates of lingual thyroidvary from 1 in 100,000 to 1 in 300,000. Review of literature reveals that only about400 symptomatic cases have been reported so far. This could well be anunderstatement and statistical anomaly.History:Hickmann recorded the first case of lingual thyroid in 1869. Montgomery stressedthat for a condition to be branded as lingual thyroid, thyroid follicles should bedemonstrated histopathologically in tissues sampled from the lesion.Common locations of ectopic thyroid gland include:1.
Between geniohyoid and mylohyoid muscles (sublingual thyroid)2.
Above the hyoid bone (suprahyoid prelaryngeal)3.
Mesentery of small intestine13.
Adrenal glandEmbryology:A brief discussion of embryology of thyroid gland will not be out of place as thiswould ensure better understanding of the pathophysiology involved in the formationof ectopic thyoid gland.Initially thyroid gland appears as proliferation of endodermal tissue in the floor of thepharynx between tuberculum impar and hypobranchial eminence (this area is the laterforamen caecum). Cells of thyroid gland descend into the mesoderm above aortic sacinto the hypopharyngeal eminence (later pharynx) as cords of cells. During thisdescent thyroid tissue retains its communication with foramen cecum. Thiscommunication is known as thyroglossal duct. This duct disappears as soon as the