Ectopic thyroid tissue

History and clinical findings: A 86-year-old woman was hospitalized two day s before death. Her past history included essential hypertension and joint pain. Electrocardiography and laboratory findings revealed an acute myocard ial infarction. Chemical laboratory examination demonstrated hyperthyreoidi sm. The xray of the chest showed a tumor-like mass in the right lung and a nodular goiter with focal changes. Sonographically a tumor in the left colo n was diagnosed. Inspite of intensive care the patient died two days later of cardiogenic shock. Autoptic diagnosis: The autopsy revealed a transmural myocardial infarction with rupture of the heart wall. An adenocarcinoma of the rectum infiltrati ng the perirectal fatty tissue was diagnosed. Metastases were absent. Addit ional to an eutopic nodular goiter there was ectopic thyroid tissue in the lung, as a tumour mass under the visceral pleura, in the pelvic cavity and in the skeleton. The histologic findings revealed a close resemblance to th e thyroid gland in normal anatomical position. In small foci in the eutopic and ectopic thyroid tissues there were signs of hyperthyroidism. There was no evidence of malignancy. Conclusion:One should always keep in mind that manifest hyperthyroidism, no t explicable on the grounds of the thyroid findings in normal anatomical po sition can point to ectopic (multilocular) thyroid tissue, especially when there are "tumours" of uncertain origin.