Rediscovering the physical exam: lingual thyroid in juvenile hypothyroidism- a case report

BACKGROUND AND NOVELTY: Lingual thyroid is a rare congenital malformation. The symptoms of lingual thyroid range from hypothyroidism to dysphagia and even sleep apnea. However, it can be difficult to diagnose in asymptomatic children. The novelty of this case stands from the early detection of lingual thyroid prior to the onset of local manifestation, emphasizing the value of meticulous physical examination. CASE REPORT: We present a case of 5 years old girl who had growth failure and no local symptoms, Clinical examination revealed stunting along with a 2-cm size mass in the oral cavity. Her biochemical tests suggested hypothyroidism and ectopic location of thyroid at the base of the tongue was identified as the cause. She was managed with thyroid hormone replacement therapy and experienced a reduction in mass size. CONCLUSION: A careful clinical examination remains crucial for identifying diagnostic clues in resource-limited setting. We recommend routine oral cavity examination in all suspected cases of hypothyroidism specially in pediatric age group.