CTICasesIntrathoracic (Mediastinal) Ectopic Thyroid Tissue Displacing the Trachea
Imaging findings
A 9-year-old asymptomatic patient had an incidental finding of tracheal displacement to the right with excessive separation from the aortic arch, more than expected for the arch alone; thick-slab sagittal reconstructions and a nuclear thyroid scan confirmed a tongue of thyroid tissue descending sparsely down the left side of the mediastinum before bulging and displacing the trachea and esophagus, consistent with intrathoracic (ectopic/substernal) thyroid tissue.
Key takeaways
Unexplained tracheal displacement with an epicenter of deviation distinct from the expected relationship to the aortic arch should prompt a search for ectopic mediastinal tissue such as intrathoracic thyroid, which can be confirmed with a nuclear thyroid scan; when asymptomatic and not causing airway compromise, such incidental ectopic thyroid tissue can reasonably be observed without intervention.
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