sodium-pertechnetate-tc-99m and Tongue-Neoplasms

Alveolar soft-part sarcoma (ASPS) is a rare and often fatal tumor. Overall survival rates have been reported to be 62% after 5 years, 42% after 10 years, and 18% after 20 years. ASPS accounts for 5% of all pediatric soft-tissue sarcomas other than rhabdomyosarcomas. In children, ASPS rarely occurs in the oral cavity, and to the best of our knowledge, only 12 cases of ASPS of the tongue occurring during the first decade of life have been previously reported in the literature. Because of the rarity of lingual ASPS in children, no specific treatment protocols have been developed, which makes its management difficult. We report a new case of lingual ASPS in a young child. Our patient was a 17-month-old girl whose tumor was located at the base of the tongue. She was successfully treated with surgical excision without adjuvant radiation or chemotherapy. Postoperatively, she has remained disease-free during 4 years of follow-up.

Topics: Biopsy; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Infant; Magnetic Resonance Imaging; Neoplasm Staging; Neoplasm, Residual; Radionuclide Imaging; Sarcoma, Alveolar Soft Part; Sodium Pertechnetate Tc 99m; Tomography, X-Ray Computed; Tongue; Tongue Neoplasms

Topics: Contrast Media; Humans; Iodine Radioisotopes; Lingual Thyroid; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Neoplasms; Thyroxine; Tomography, X-Ray Computed; Tongue Neoplasms

Congenital rests of gastric epithelium have been reported in a variety of head and neck locations. Presenting symptoms of these lesions range from an asymptomatic cyst to one which is compromising the airway. The true diagnosis is rarely suspected prior to excision. A case of a gastric choristoma of the tongue is presented which was noted at birth as an intermittently bleeding ulcer. Complete excision of the mass was difficult to ascertain due to poor delineation of the tumor margins from the tongue musculature. A postoperative technetium-99m pertechnetate scan failed to demonstrate residual gastric mucosa. Conservative management resulted in only transient healing of the ulcer. Repeat excision demonstrated abundant residual gastric mucosa. Technetium-99m pertechnetate scanning may not be a reliable indicator of ectopic gastric mucosa in the head and neck region.

Topics: Choristoma; Diagnosis, Differential; Humans; Infant, Newborn; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stomach; Tongue Diseases; Tongue Neoplasms; Ulcer

Thyroid scintigraphy was performed in 69 consecutive infants with permanent primary congenital hypothyroidism (CH) detected by systematic neonatal thyroid screening using a rectilinear scanner or a gamma camera 15 minutes after the intravenous injection of 250 microCi Tc-99m sodium pertechnetate, immediately after the infants were fed. Immobilization of the infant in a supine position with the neck in hyperextension was achieved by a vacuum cushion without any sedation. Thyroid scintigraphy showed thyroid ectopia in 43 of the 69 CH infants, thyroid agenesis in 19, and goiter in the last 7 infants, respectively. The images were easily interpretable in all cases, even in very small ectopic glands in the lingual area, as there was no interference with extra-thyroidal uptake of the tracer, especially by the salivary glands. Our experience indicates that thyroid scintigraphy in the CH newborns can be performed immediately at the time of diagnosis of CH without technical difficulties. As thyroid scintigraphy is the only procedure allowing the distinction between thyroid agenesis and ectopia, and as the neurointellectual prognosis might be lower in the former than in the latter situation, thyroid scintigraphy in CH newborns contributes not only to the diagnosis but also the prognosis of the disorder.

Topics: Choristoma; Congenital Hypothyroidism; Humans; Hypothyroidism; Infant, Newborn; Neonatal Screening; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Gland; Tongue Neoplasms

Technetium 99m pertechnetate thyroid scans were performed on 57 infants referred for evaluation of suspected congenital hypothyroidism. Thyroid anatomy may be characterized by four general types, based on the scintigraphic findings: (1) normal size and location; (2) ectopic location; (3) no detectable thyroid activity; (4) normal location with increased size or uptake. There are diverse etiologies of congenital hypothyroidism. Correlation of thyroid scintigraphy with blood T4 and TSH levels allows specific etiological diagnosis in the majority of cases of congenital hypothyroidism.

Topics: Choristoma; Congenital Hypothyroidism; Female; Humans; Hypothyroidism; Infant, Newborn; Male; Mass Screening; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Gland; Thyroid Hormones; Thyrotropin; Tongue Neoplasms

A 72-yr-old woman who had previously undergone partial thyroidectomy for "toxic goiter" and subhyoid gland resection presented with signs and symptoms of ectopic lingual thyroid at the base of the tongue. The combination of lingual subhyoid and pretracheal thyroid is a rarity with only three cases reported. Discovery of ectopic thyroid tissue should raise suspicion of other ectopic thyroid tissues along the path of embryologic migration from its origin to the porta hepatis. This may necessitate assessment of radionuclide uptake and imaging of numerous areas. Sodium levothyroxine is the mainstay of therapy. In patients with obstructive symptoms, 131I ablation of the ectopic thyroid tissues has proven successful and may be more advantageous than surgery. In addition, radioiodide studies during ablation therapy gave new information that the ectopic lingual thyroid had more rapid iodide turnover compared with the postsurgical pretracheal thyroid gland.

Topics: Aged; Choristoma; Female; Humans; Iodine Radioisotopes; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Function Tests; Thyroid Gland; Tongue Neoplasms

Topics: Adolescent; Child; Choristoma; Female; Humans; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Gland; Tongue Neoplasms