Introduction usually located in the midline neck typically is hypoactive thyroid tissue Presentation Symptoms dysphagia for solids hypothyroidism if tissue is hypoactive Physical exam palpation of midline mass Evaluation 123I scan identifies location of thyroid tissue Treatment Surgical excision if mass is obstructive commonly requires hormone supplementation following excision as this may be the only functioning thyroid tissue in the body Medical thyroxine supression radioactive iodine ablation