Thyroid

Introduction : Mediastinal Ectopic Thyroid Gland is a rare entity, accounting for 1% of all mediastinal tumours. Here, we present a rare case of mediastinal mass that was proved to be an ectopic thyroid with normal thyroid function tests and normal thyroid gland in the cervical location. We report in this article two cases illustrating this location. 1st clinical case : 66-year-old woman operated on for benign breast cysts consulted for progressive chest pain. The clinical examination was without abnormalities. The standard biological assessment was normal. Cervicothoracic CT showed two heterogeneous enhancement tissue mediastinal masses, a heterogeneous thyroid gland of normal volume. The surgical procedure consisted of a thymectomy and the anatomopathological study concluded to an intra-thymic ectopic thyroid adenoma. 2nd clinical case : 57-year-old woman consulted for a chronic cough. No anomaly objectified at the clinical examination. The biological assessment including thyroid was normal. The CT scan showed formation of the cervicothoracic orifice whose density evoked a thyroid or parathyroid nodule. The mass was excised and the pathology found a thyroid parenchyma with no signs of malignancy. Comments and conclusion: Transcription factor mutations are implicated in thyroid ectopy. Several locations have been described. The mediastinal localization is exceptional. The presence of a eutopic thyroid is frequently associated with the mediastinal location of ectopia. Clinical-biological euthyroidism is as well. Therapeutically, surgery may be indicated in dyspnea or other disabling symptoms.

This article delves into the intricate relationships between Type 1 Diabetes Mellitus (T1DM), thyroid function, and hepatic metabolism, shedding light on the complex interplay that influences insulin sensitivity, glucose homeostasis, and liver health. The study, conducted at Al-Qadisiyah Teaching Hospital in Iraq from January 2021 to July 2021, involved 60 T1DM patients and 40 healthy controls aged 1 to 16 years. Results from the investigation revealed significant elevations in thyroid-stimulating hormone (TSH) levels among individuals with diabetes, emphasizing the intricate interplay between T1DM and thyroid function. Moreover, T1DM patients exhibited marked increases in liver enzymes and bilirubin levels, underscoring the potential hepatocellular implications associated with metabolic dysregulation. Our findings highlight the augmented production of TSH in individuals with diabetes as a potential defensive mechanism to mitigate the consequences of elevated blood glucose. The crucial role of triiodothyronine (T3) in enhancing insulin sensitivity and reducing serum blood glucose levels is emphasized, reinforcing its position as a key player in glucose metabolism. On hepatic level, the presence of advanced glycation end-products (AGEs) in diabetes amplifies oxidative stress, potentially leading to inflammation and tissue damage in the liver. The study illustrates a model of interaction between hepatic metabolism and T1DM, highlighting the impact of diabetes on liver apoptosis, bilirubin metabolism, and the intricate interplay between high blood sugar levels, AGEs, and red blood cell (RBC) membranes. Our findings provide comprehensive insights into the interconnected dynamics of T1DM, thyroid function, and hepatic metabolism, contributing to a deeper understanding of the complex physiological interactions within the context of diabetes mellitus.