# Dual ectopy: Unique appearance of ectopic thyroid

## TL;DR

A 67-year-old woman had two ectopic thyroid tissues found at the base of her tongue and hyoid bone, confirmed through imaging and biopsy.

## Contribution

This case highlights the unique occurrence of dual ectopy in thyroid tissue and emphasizes the importance of embryologic development in diagnosing heterotopic tissue.

## Key findings

- Two ectopic thyroid lesions were identified at the base of the tongue and hyoid bone.
- The lesions were confirmed as ectopic thyroid tissue through imaging and biopsy.
- The case underscores the need to consider thyroid developmental anomalies in midline neck lesions.

## Abstract

A 67-year-old female underwent a computed tomography angiogram (CTA) of the head in the setting of acute, short-term memory loss. Two lobulated hyperattenuating lesions were incidentally discovered at the base of the tongue and the hyoid bone. Upon further investigation in the outpatient setting including further imaging and ultrasound-guided biopsy, the lesions were confirmed to be ectopic thyroid tissue with dual ectopy. Heterotopic tissue, especially when arising at separate sites, can be concerning for a broad differential diagnosis including malignancy, and further evaluation is certainly recommended. When evaluating possible heterotopic tissue, one must always keep in mind the expected embryologic development of the organ in question. Further, in cases where biopsy is less favorable, consideration of the heterotopic tissue's expected physiology is equally important. With these 2 facts in mind, midline hyperattenuating, enhancing lesions in the neck must always be considered to be a possible developmental anomaly of the thyroid, even when there are multiple lesions.