ABSTRACT Introduction: Thyroid ectopy is described as the presence of thyroid tissue in a location that is different from that of its usual in the lower anterior neck. It has very low prevalence and it finds its origin in disruptions in the descent from the base of the tongue to its final position during gland embriogenesis. The diagnosis is based on imaging tests and histologic studies, the treatment varies according to its location, symptoms and hormonal functionality. Double thyroid ectopy is a very rare finding, with approximately 40 cases described in the literature. Case presentation: We present a 39 year old female patient who was under follow up because of a double thyroid ectopic tissue: in the tongue base and left submandibular locations. She was derived to our Department after a growth of the submandibular subunit in the last year was detected in the computed tomography scan (CT). She was asymptomatic and thyroid functionality tests were normal. Surgical treatment of the submandibular thyroid tissue was consensuated, with a modified Risdon like approach, and monitoring of the nodule at the base of the tongue. Discussion: Thyroid ectopic tissue is a very infrequent finding and even rarer is a double ectopy. We present a patient in which a surgical approach was decided after observing a growth in one of the ectopia nodules even though she was in a euthyroidism hormonal state.

RESUMEN Introducción: Se denomina tiroides ectópico a la presencia de tejido tiroideo en una localización distinta de su habitual. Es de prevalencia muy baja y tiene su origen en alteraciones del trayecto de descenso de la glándula desde la base de la lengua hasta su posición final cervical anterior durante el desarrollo. El diagnóstico se basa en pruebas de imagen y el estudio histológico. El tratamiento varía según su localización, síntomas y funcionalidad hormonal. La ectopia doble es una situación muy infrecuente, con alrededor de 40 casos descritos en la literatura. Caso clínico: Presentamos una mujer de 39 años en seguimiento por tejido tiroideo ectópico doble en la base de la lengua y submandibular izquierda derivada a nuestras consultas por crecimiento en el último año del nódulo submandibular objetivado en la tomografía computarizada (TC) cervicofacial de control. La paciente se encontraba asintomática y las pruebas de función tiroidea eran normales. Se decidió tratamiento quirúrgico del tejido de localización submandibular con un abordaje tipo Risdon modificado y vigilancia periódica del nódulo situado en la base lingual. Discusión: El tejido tiroideo ectópico es un hallazgo muy infrecuente y la ectopia doble es aún más infrecuente. Presentamos el caso de una paciente en la que se decidió manejo quirúrgico por crecimiento de uno de los nódulos a pesar de encontrarse en un estado de eutiroidismo.

Paciente com timoma e função sistólica normal do ventrículo esquerdo desenvolveu tamponamento cardíaco, revertido por pericardiocentese. Após quatro dias, foi submetida à exérese do tumor e, em aproximadamente uma semana da drenagem, apresentou disfunção sistólica aguda e grave do ventrículo esquerdo, que melhorou com terapia venosa, normalizando o quadro em três dias.

A patient with a thymoma and initially normal ventricular systolic function developed cardiac tamponade, which was relieved by pericardiocentesis. After four days, the tumor was removed and, one week after the relief of tamponade, she developed severe left ventricular systolic dysfunction, that recovered in three days with venous therapy.