Extrathyroidal

Extrathyroidal is an adjective used in medicine to describe tissue, lesions, or processes that occur or extend outside the thyroid gland. It is most commonly used in the context of thyroid disease, but can refer to any structure located outside the thyroid.

Anatomically, the thyroid gland sits in the neck anterior to the trachea and is enclosed by a fibrous capsule. Extrathyroidal refers to tissues beyond that capsule, such as strap muscles, pretracheal fascia, the larynx and trachea, esophagus, carotid sheath, and surrounding soft tissues. The term is also used to describe lymph nodes or metastases that originate outside the thyroid but are found in the neck.

Clinical relevance is greatest in thyroid cancer. Extrathyroidal extension (ETE) denotes tumor invasion beyond the thyroid capsule into perithyroidal soft tissues. This finding, which can be microscopic or gross, upstages disease in several staging systems and often influences treatment decisions, including surgical approach and the need for adjuvant therapy.

Imaging modalities such as high-resolution ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and sometimes positron emission tomography (PET) help assess ETE and delineate involved structures. Accurate assessment guides surgeons in planning resection margins and in predicting prognosis.

Outside cancer, extrathyroidal can describe non-thyroidal processes located outside the gland, such as ectopic thyroid tissue or extrathyroidal goiter, though such terms are used less commonly and require context.