case_images: PMC11071174_01
case_images: Preoperative abdominal CT imaging. (A) Arterial phase demonstrated ovoid mass with clear borders and markedly homogeneous enhancement. (B) Portal phase showed persistent enhancement. (C) Delayed phase indicated persistent enhancement, and the degree of enhancement was basically the same as that in the arterial phase. Red arrows indicated the mass, yellow arrows showed the gallbladder and intracystic stones, and blue arrows implied the common bile duct. Preoperative abdominal MRI and MRCP imaging. (D) Coronal T2WI indicated a mass located at the hepato-duodenal ligament with ovoid in shape and clear borders. The mass was also adjacent to the common bile duct. (E) T2WI showed isotropic signals. (F) DWI demonstrated isotropic plus slightly hyperintense signals. (G) T1WI also showed isotropic signals. (H) MRCP showed no dilatation of the bile ducts and no compression. Red arrow indicated the mass and yellow arrow indicated the bile duct.
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case_images: The arterial phase, portal venous phase and delayed phase all showed uniform enhancement, with no indications of compression or invasion into surrounding organs and tissues ( Figures 1A-C ). MRCP showed no signs of compression or dilation of the intrahepatic or extrahepatic bile ducts ( Figures 1D-H ).
case_images: Typical images of surgical procedures. (A) Laparotomy was performed, and yellow arrow indicated the mass, red arrow indicated the gallbladder and blue arrow indicated the common bile duct. The mass was located anterior to the hepato-duodenal ligament, and the common bile duct was posterior to the mass. (B) Ultrasonic scalpel was applied to resect the mass, which showed the sparse tissues between the wall of the mass and the common bile duct. (C) Trauma surface of the mass after complete resection.
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case_images: During intraoperative exploration ( Figure 2 ), it was observed that the gallbladder displayed signs of chronic inflammation, with palpable stones within.
case_images: Pathological confirmation of specimen. (A) Hematoxylin-eosin staining showed differentiated thyroid tissue (x100). (B) Immunohistochemical staining demonstrated that intraoperative specimen was positive for thyroid transcription factor-1 (x200). (C) Immunohistochemical staining indicated that intraoperative specimen was positive for thyroglobulin (x200). Postoperative abdominal CT imaging after six-month follow-up. (D) Postoperative CT imaging showed alterations after gallbladder and ectopic thyroidectomy. Yellow arrow indicated the common bile duct.
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case_images: Based on the morphological and immunohistochemical results ( Figures 3A-C ), the mass was diagnosed as ectopic thyroid. There were no abnormalities in abdominal CT and thyroid function tests six months after the operation ( Figure 3D ), and there were no abnormalities in the patient's thyroid ultrasonography and thyroid function during follow-up for the next four years.