Image in endocrinology: Intratracheal ectopic thyroid mass.

A 39-yr-old woman presented with dyspnea and cough. She had undergone total thyroidectomy for multinodular goiter 15 yr earlier, with subsequent T4 replacement therapy. Inspiratory stridor was noted. Serum TSH was 2.95 mIU/ml (normal, 0.3–4.0 mIU/ml). A magnetic resonance image (MRI) of the neck showed a subglottic tumor with severe occlusion of the trachea (Figs. 1 and 2). Direct laryngoscopy revealed a subglottic mass covered with normal mucosa. Tc scintigraphy showed homogenous subglottic uptake compatible with a thyroid tissue. A transtracheal surgical approach was used to remove the tumor. Pathology showed a follicular thyroid tissue with no features of malignancy.