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Y -M Gu, Y -Y Fan, W -P Wang, L -Q Chen, Ectopic thyroid tissue in the heart, QJM: An International Journal of Medicine, Volume 112, Issue 12, December 2019, Pages 927–928, https://doi.org/10.1093/qjmed/hcz219
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Case presentation
A 55-year-old man was referred to our hospital with an asymptomatic cardiac mass detected incidentally on chest computed tomography (CT) 1 month ago. He denied any history of malignancy and thoracic trauma.Physical examinations, ECG and his laboratory tests were unremarkable. Echocardiography disclosed a 3 × 3 × 2 cm cardiac mass adjacent to the aortic root. The chest CT scan revealed a 32 × 19 × 28 mm rounded tumor of hyperdensity with well-defined margins located between the aortic root and pulmonary artery trunk, which were significantly enhanced by contrast scan (Figure 1A). To exclude malignancy and other masses PET-CT with fluorine-18-labelled fluorodeoxyglucose (FDG) was done; it showed a mass ventrolateral to the aortic root without FDG uptake. Probably due to several important anatomical structures surrounding the mass, no diagnosis could be made with biopsy before surgery. The mass was resected using thoracoscopic techniques. As indicated by the CT scan, the tumor had no infiltrative growth. Histology demonstrated an encapsulated multinodular tumor with some small focal calcifications in the center (Figure 1B). Microscopy confirmed no neoplastic cells were found in the mass but only the typical features of normal thyroid cells (Figure 1C). Immunohistochemical staining of the mass tissue revealed a positive reaction for thyroid transcription factor-1, thyroglobulin, phosphoenolpyruvate carboxykinase and negative reaction for cytokine 5/6 (CK5/6) and protein 53 (p53). The final diagnosis was an intrapericardial ectopic thyroid. The FT3, FT4 and TSH levels prior to and after surgery were normal. The patient had an uneventful postoperative course and was asymptomatic in 6-month follow-up.
