Autotransplantation in Lingual Ectopia of the Thyroid Gland* Review of the Literature and Report of a Successful Case By

Though 'lingual thyroid' has been an accepted term for many years, precise terminology might be served better by the use of ectopia to indicate those cases-the majority-in which no thyroid tissue exists in the orthotopic (prelaryngeal) site, the prefix lingual indicating the site of ectopia. Ectopia also serves to describe the situation in which a 'thyroglossal cyst' is solid and represents the only thyroid tissue which the patient possesses. Such cases are analogous to lingual ectopia, the difference lying in the point at which migration is arrested. If this designation is accepted, the term 'aberrant thyroid' could be reserved for those cases in which orthotopic thyroid tissue coexists. The introduction of radioactive iodine 1131 uptake surveys has made it possible to determine the exact site or sites of functioning thyroid tissue, and has displaced both biopsy of ectopic lingual tissue and cervical exploration for orthotopic thyroid. Since Hickman (1869) described the first case, experience of lingual ectopia of the thyroid gland has steadily accumulated and there are now over 200 cases on record. Montgomery (1936) in a critical review suggested criteria for authenticity and at that time accepted 144 cases as proven. His criteria were: 1. A lingual tumour situated between the epiglottis and the circumvallate papillae. 2. Biopsy of the tumour demonstrating the presence of thyroid tissue. 3. As an alternative, the supervention of a hypothyroid state on operative removal of the tumour. Clinical signs or symptoms have appeared during puberty or adolescence in almost half of the cases recorded. They can be summarized as follows: 1. The most common symptoms were those of oropharyngeal obstruction, e.g. dysphagia, dysarthria, dyspnoea, orthopnoea. 2. Haemorrhage, often recurrent and in small