Introduction: This report describes an asymptomatic 63-year-old female with a right paratracheal mass compressing and displacing the trachea to the left. Additionally, the epidemiology, clinical manifestation, diagnosis, and management of mediastinal ectopic thyroids are discussed.
Case Summary: A 63 y/o female with history of hypertension, myasthenia gravis and Type 2 diabetes mellitus had a hospitalization for pneumonia and was incidentally found via chest CT scan with a right paratracheal soft tissue mass with few coarse calcifications measuring 7.5 cm displacing the trachea to the left without compromise of the lumen. She was referred to a local cardiothoracic surgeon and underwent elective right thoracot-omy with resection of the mediastinal mass and mediastinal lymph node.
Results: Microscopic evalua-tion of numerous sections consisted of essentially unremarkable thyroid tissue with common follicular arrangements. No malignancy was present. Consultation with the radiology department established that the mass was separated from the still in place unremarkable native thyroid confirming a diagnosis of ectopic thyroid tissue. Discussion: Mediastinal thyroid tissue may present differently based on its loca-tion, size, and function. Many patients are asymptomatic, with the condition discovered incidentally dur-ing imaging or unrelated surgery. Symptoms can arise if the tissue is large or compresses nearby struc-tures, causing chest pain, cough, or difficulty breathing. Functional ectopic thyroid tissue may lead to endocrine symptoms from hyperthyroidism or hypothyroidism. Case reports highlight various presenta-tions, from respiratory distress to incidental findings during routine exams.
Conclusion: Accurate diag-nosis and management of ectopic thyroid rely on using a combination of imaging studies and histological examination to confirm the presence of the thyroid tissue. Treatment for ectopic thyroid tissue depends on the characteristics of symptoms and concerns about malignancy.