On October 30, 1997, Guangzhou Daily reported that the Beijing Children’s Hospital mistakenly removed the thyroid gland of a 10-year-old boy, Wang Mou, and concealed it from the patient for four years. The parents of the child filed a complaint with the local court, requesting the hospital to compensate the child 1.64 million yuan for economic and mental losses, a record price for medical compensation in China. The Beijing Xicheng District People’s Court has officially opened a case for acceptance. In recent years, there have been a number of cases of wrongful removal of the thyroid gland, and the causes of the accidents are not only related to the personal responsibility of the operator, but also related to the physiological abnormality of the thyroid gland itself. In the fourth week of human embryonic development, the thyroid embryonic base is formed in the middle of the wall of the pharyngeal floor between the first and second parotid arches. This embryonic primordium develops downward and backward in a tubular shape, and then divides into multiple cord-shaped cell clusters to form the isthmus and lateral lobes of the thyroid gland. As the thyroid gland develops toward the neck, it forms the thyroglossal duct, which later becomes atretic and degenerates. In the adult, the tongue’s blind foramen corresponds to the upper end of this duct, and the lower end forms the conical lobe of the thyroid gland. From the above embryonic developmental route, it can be seen that if the thyroglossal duct fails to close, the epithelial secretions gathered with the duct to form a cyst called thyroglossal bone. If the thyroid gland descends abnormally, ectopic thyroid may appear: 1, lingual thyroid, occurring at the blind hole of the tongue; 2, intratympanic thyroid, located in the internal body of the tongue; 3, sublingual thyroid; 4, anterior laryngeal thyroid; 5, the upper mediastinal thyroid, caused by the descent to the back of the sternum; 6, there are also nasopharyngeal, esophageal, tracheal thyroid, and so on. Ectopic thyroid is divided into parathyroid and vagus thyroid. The parathyroid gland is an extra gland other than the normal thyroid gland, and its position is uncertain, but there is a certain distance from the normal thyroid gland. The vagus thyroid is an abnormal location of the entire thyroid gland, and there is no thyroid tissue in the normal anatomical location of the neck. Therefore, an ectopic thyroid gland can be a parathyroid gland or a vagus thyroid gland. The thyroid gland is an important endocrine organ in the body, and its main functions are to take up and store iodine, and to synthesize and secrete thyroxine. Thyroxin promotes various metabolic activities in cells and increases the physiological activities of organs. The parafollicular cells (C cells) in the thyroid gland also secrete calcitonin, which is involved in the regulation of calcium and phosphorus metabolism. If the thyroid gland is lost, children or adults will require lifelong thyroxine supplementation. Children can also suffer from impaired growth due to calcitonin deficiency. Delayed treatment can result in lifelong disability. Symptoms caused by an ectopic thyroid gland depend on its anatomical location and size. For example, smaller thyroid glands at the base of the tongue may be asymptomatic; larger ones may cause swallowing, dysphagia and dyspnea, as well as pharyngeal foreign body sensation, sore throat, and hemorrhage; symptoms similar to those of normally located thyroid glands, such as hyperthyroidism, may also occur. For patients who consult the doctor for swelling in the anterior cervical region or at the base of the tongue, the doctor must carefully identify whether it is an ectopic thyroid gland. The diagnosis should be made by noting whether the swelling at the base of the tongue or in the front of the neck is a thyroid gland and whether there is thyroid tissue in the normal anatomical location. This can be determined by iodine absorption measurements, and isotope scans. If the iodine absorption rate is elevated in the sub-chin region, the diagnosis of the sublingual and root of the tongue as thyroid can be confirmed; isotope scanning is more valuable if the diagnosis is made, as it clearly shows whether it is thyroid or not, and whether there is any thyroid tissue in the normal anatomical location. Once the diagnosis of a vagal thyroid is confirmed, it is necessary to take into account the general condition and age; careful consideration should be given to the question of removal; if it is a parathyroid gland, there are no adverse consequences after removal. Wang Mou, a 10-year-old boy, was treated as a thyroglossal cyst by the doctor because of a small lump on his neck, and he did not tell his family afterwards, which caused the patient and his family to interrupt the thyroxine treatment, and a series of hypothyroidism symptoms appeared, such as generalized edema, and sudden nearsightedness of eyes. A series of hypothyroid symptoms appeared. Delayed treatment leads to lifelong disability for the patient. Talk about thyroglossal cysts Thyroglossal cysts are common midline neck cysts that can occur anywhere from the blind hole of the tongue to the incision of the sternal stalk. During the fourth week of human embryonic development, the thyroid embryonic base is formed between the first and second parotid arches, which in turn develops into the thyroid gland and extends downward to its normal thyroid position with the help of the attached thyroglossal duct. In the sixth week of the embryo, the thyroglossal duct begins to degenerate and atreticates into a cord, the upper end of which degenerates into a small concavity called the lingual foramen ovale. If the lower end fails to degenerate and atresia, in this case, with the epithelial secretion in the duct to form a cyst that protrudes between the thyroid cartilage and the hyoid bone, called a thyroglossal cyst. The cyst may become infected, suppurate and puncture, or recur due to surgical failure to cut cleanly and form a fistula, called thyroglossal fistula. Clinical manifestations: 4 weeks after birth to adolescents appear in front of the neck 2-3 centimeters in diameter, round, smooth and painless cystic swelling, moving up and down with swallowing. Cystic contents of light yellow thin or mucous peripheral fluid, pus fluid after infection. Those located at the base of the tongue should be differentiated from the root thyroid. Located in the lower neck thyroid tumor identification. Treatment: Surgical excision. Children can be operated after 2 years of age. The main point is that the cyst must be removed together with the middle part of the hyoid bone, otherwise it is prone to recurrence.