{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T22:44:20Z","timestamp":1774478660985,"version":"3.50.1"},"reference-count":7,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,4,23]]},"abstract":"<jats:p>A 31-year-old woman with papillary carcinoma of the thyroid with right cervical lymph nodal metastasis underwent total thyroidectomy with modified radical neck dissection. At follow-up 6\u2005weeks after surgery, she had not developed clinical features of hypothyroidism and her thyroid-stimulating hormone (TSH) was within normal limits. Further evaluation including technetium scintigraphy of the thyroid and MRI of the chest confirmed thyroid tissue, thyrothymic thyroid rest (TTR), in the superior mediastinum. The patient's TSH elevated well after reoperation of TTR. She underwent radioiodine ablative therapy and suppressive thyroxine therapy as per the protocol for well-differentiated thyroid cancer follow-up. The clinical importance of these embryological rests of thyroid tissue, especially in the management of thyroid malignancies, is discussed in this report.<\/jats:p>","DOI":"10.1136\/bcr-2015-209809","type":"journal-article","created":{"date-parts":[[2015,5,15]],"date-time":"2015-05-15T04:05:04Z","timestamp":1431662704000},"page":"bcr2015209809","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Non-elevation of TSH after total thyroidectomy: a surgical surprise"],"prefix":"10.1136","volume":"2015","author":[{"given":"Dhalapathy","family":"Sadacharan","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery, Madras Medical College, Chennai, Tamil Nadu, India"},{"name":"Department of Endocrinology and Endocrine Surgery, Endocrine and Speciality clinic, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shriraam","family":"Mahadevan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Endocrine Surgery, Endocrine and Speciality clinic, Chennai, Tamil Nadu, India"},{"name":"Department of Endocrinology, Sri Ramachandra Medical College, Chennai, Tamilnadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sankaran","family":"Muthukumar","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Madras Medical College, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanmugasundaram","family":"Dinesh","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, Madras Medical College, Chennai, Tamilnadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,5,15]]},"reference":[{"key":"2025082801544115000_2015.may15_1.bcr2015209809.1","unstructured":"Agarwal A , Mishra AK , Lombardi CP , et al . Applied embryology of the thyroid and parathyroid glands. In: Randolph GW . Surgery of the thyroid and parathyroid glands. 2nd edn. 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