Sublingual Ectopic Thyroid Gland Misdiagnosed as Atrophic Hashimoto’s Thyroiditis: A Case Report

Aleksandar Botushanov; Nikolay Botushanov; Albena  Botushanova

doi:10.3889/oamjms.2025.12059

Authors

Aleksandar Botushanov Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria https://orcid.org/0000-0002-0011-6738
Nikolay Botushanov Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria https://orcid.org/0000-0002-4183-5341
Albena Botushanova Department of Clinical Oncology, Medical University Plovdiv, Plovdiv, Bulgaria https://orcid.org/0000-0003-2286-0936

DOI:

https://doi.org/10.3889/oamjms.2025.12059

Keywords:

ectopic thyroid gland, sublingual thyroid, hypothyroidism, ultrasound, SPECT/CT with 99mTc

Abstract

BACKGROUND: Ectopic thyroid gland is a rare developmental anomaly caused by aberrant migration of thyroid tissue during embryogenesis. Misdiagnosis as autoimmune thyroiditis, particularly the atrophic form, may occur due to overlapping clinical features, especially in the hypothyroid state.

CASE PRESENTATION: We report the case of a patient who was treated for autoimmune thyroiditis for more than 20 years. Comprehensive imaging with ultrasound and SPECT/CT ultimately revealed an ectopic sublingual thyroid gland, with no orthotopic thyroid tissue present.

CONCLUSION: This case underscores the importance of thorough imaging evaluation in patients with hypothyroidism and absent thyroid tissue in the normal anatomical location, to avoid prolonged misdiagnosis and inappropriate management.

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