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Radiology Case
Presentation
Hillel Sternlicht
UVA School of Medicine
July 18, 2008
The Patient
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10 yo Female who presents
with recurrent otitis media
Upon physical exam, pt noted
to have mass at base of
tongue.
Pt herself asymptomatic.
Hx only significant for
grandfather with
hypothyroidism and possible
papillary thyroid CA
The Differential
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Thyroglossal duct cyst:U/S demonstrates
midline,hypoechoic mass.CT and MRI show
uncomplicated cyst with uniform density
Lingual Dermoid Cyst: Fatty contents such as fat-fluid
level is pathognomonic for dermoid cyst. MR of
epidermoid cyst show fluid-filled lesion with
hypointense signal on T1 and hyperintense on T2 A
slight rim enhancement around these cysts can
sometimes be noted.
Lingual Thyroid: Hyperdense on post-contrast CT or
MRI. On pre-contrast MRI, it may be only slightly
hyperintense on both T1- and T2-weighted images.
Thyroid scintigraphy is the most definitive non-invasive
technique for establishing the diagnosis of thyroid
ectopia.
Imaging Findings: MRI
Round, well circumscribed 2.5 x 2.5 cm mass at midline tongue base,
demonstrating intermixed areas of cystic change
Imaging Findings: Uptake Scan
Increased radiotracer uptake in the region of the tongue base. No
significant radiotracer uptake is noted in the expected
region of the thyroid bed
References
Beil CM, Keberle M. Oral and
oropharyngeal tumors. Eur J Radiol.
2008;66(3):448-59
 Hod N, Mindlin L, etal. Double ectopic
thyroid. Pediatr Radiol 2002;32:85-61.
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Radiology