Lingual thyroid is a rare developmental disorder and is more frequent
in women. The pathogenesis is unclear but may be related to the presen
ce of maternal blocking autoantibodies against the thyroid. Treatment
of this disorder includes the use of levothyroxine in order to correct
the hypothyroidism, which is very frequent and to induce the shrinkag
e of the gland. When symptoms of obstruction or bleeding appear, ablat
ive therapy by means of surgery or radioiodine is warranted. We report
three cases and discuss the approach to diagnosis and a strategy for
management.