Lateral Aberrant Thyroid: Causes, Diagnosis And Treatment

Lateral aberrant thyroid (LAT) refers to a mass of thyroid tissue present in the lateral neck region, specifically adjacent to the jugular vein. Microscopically, these tumours have a papillary structure similar to those found in thyroid gland tumours.

However, they are not composed of the tissues which are found in the thyroid gland. Rather, they do not have any relation with the endocrine gland itself.

This article covers the anatomy of the thyroid gland, causes of lateral aberrant thyroid, its symptoms, diagnostic approaches, treatment options, and more.

Anatomy of the Thyroid Gland

The thyroid is a butterfly-shaped endocrine gland that is located at the front of a person’s neck. It consists of two lobes connected in the middle by a narrow band of tissue called the thyroid isthmus. 

In some rare cases, people tend to have ectopic thyroid tissues. They are functional thyroid tissues that can be located anywhere in the body apart from the original anatomical position. Lateral aberrant thyroids generally occur as a result of this anomaly.

Causes of Lateral Aberrant Thyroid

Discussed below are some of the common causes of LAT:

• Lateral aberrant thyroid occurs due to a rare developmental defect that takes place during the early stages of thyroid gland embryogenesis, when it moves from the floor of the primitive foregut to its final pre-tracheal position.
• In most cases, these anomalies occur during the 7th week of gestation and are found in approximately 1 in 100,000–300,000 individuals.
• Computed tomography (CT) results reveal that lateral aberrant thyroid tissues can be formed as a result of factors like a continuation from the cervical thyroid gland (metastasis of a primary thyroid malignancy), focal calcification, and non-contrast attenuation of the thyroid tissue in comparison to the surrounding tissue.

Clinical Presentation of Lateral Aberrant Thyroid

A majority of lateral aberrant thyroid cases are asymptomatic. However, symptoms are visible if there is an increase in the size of the tissues or in the case of people who have existing thyroid-related disorders.

Reports from clinical examinations indicate symptoms like a smooth marginal mass with a soft consistency that is mobile and not tender. However, it is different from subcutaneous swellings and neoplasms, like epidermal cysts, thyroglossal duct cysts, lipomas, etc.    

Diagnostic Approach for Lateral Aberrant Thyroid

Discussed below are the general diagnostic processes for LAT:

• The diagnostic approaches for lateral aberrant thyroid include imaging techniques like MRI, CT scan, and ultrasonography. 
• Additionally, based on the symptoms and severity, the healthcare provider may recommend thyroid function tests, radionuclide thyroid imaging, or a biopsy.  

Treatment Options for Lateral Aberrant Thyroid

Know more about the treatment options for LAT below:

• In case of asymptomatic patients, therapy is usually not required. They are kept under observation by doctors. 
• However, for patients with symptoms, treatment procedures depend upon the local symptoms (dysphonia, dysphagia, and airway obstruction), size of the gland, histological findings, and thyroid function status. 
• In cases where the lateral aberrant thyroid tissues have papillary carcinoma, the treatment method includes excision surgery and total thyroidectomy, which is followed by a radioiodine ablation and levothyroxine suppression therapy (for more refractory cases).   

Potential Complications

The potential complications of lateral aberrant thyroid are:

• Infection
• Bleeding
• Ulceration
• Cystic degeneration
• Malignancy 

In case the doctor performs total thyroidectomy and radioiodine therapy as a part of the treatment process, permanent hypothyroidism is a potential and expected complication. Additionally, there can be possible complications like accidental damage or removal of parathyroid glands and damage to the recurrent laryngeal nerve. 

Prognosis After Treatment

With prompt diagnosis and treatment, patients are reported to have a favourable prognosis. However, for asymptomatic patients, routine follow-up and monitoring are a must for doctors to timely identify any developments in the lateral aberrant thyroid tissues.

Patient Education and Lifestyle Considerations

For patients diagnosed with lateral aberrant thyroid, availing of regular check-ups is an ideal way to keep this medical condition under check. Additionally, they should consider making the following lifestyle changes to keep their overall health better: 

• Opting for regular exercise 
• Quitting smoking 
• Limiting the intake of sugar and processed food items
• Ensuring adequate hydration
• Adding nutritious foods to the diet

Conclusion

Lateral aberrant thyroid occurs due to a rare developmental defect that usually takes place during the early stages of thyroid gland embryogenesis. A majority of the cases are asymptomatic, with symptoms only being visible with an increase in the tissue size and in the case of people who have existing thyroid-related disorders. 

Treatment options include routine observation for asymptomatic patients, while surgical intervention and other therapies are recommended for symptomatic individuals based on the size of the gland, local symptoms, and other factors.