We report a rare case of ectopic lingual thyroid with a risk of strangulation. A 32-year-old female patient had a lingual tumor and computed tomography（CT） scan revealed a rounded mass with calcification, occupying the pharyngeal space. No thyroid gland was seen in the normal pretracheal position. 99mTc sintigraphy showed high uptake only in the sublingual region. In 201Tl sintigraphy, wash out was poor which might have further complicated the malignant tumor. The patient was also found to suffer from subclinical hypothyroidism. We underwent lingual thyroidectomy using an external cervical approach.
The patient had no apparent complication resulting from surgery and was discharged after two weeks.