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A Rare Case of the Double Thyroid Ima Artery Department of Anatomy

A Rare Case of the Double Thyroid Ima Artery Department of Anatomy

THE KURUME MEDICAL JOURNAL Vol. 43, p. 177-180, 1996

SHORT COMMUNICATION

A Rare Case of the Double Ima

TAKAHIKO SANNOMIYA, KOH-ICHI YAMAKI, YOSHIAKI DOI , KATSUMARO AIDA, HISATO TANAKA, YASUYUKI HYAKUTAKE AND MITSUAKI YOSHIZUKA Department of Anatomy, Kurume University School of Medicine, Kurume 880, and *Department of Anatomy, University of Occupational and Environmental Health, Kitakyushu 807, Japan

Received for publication March 15, 1996

Key words: human anatomy, artery, anomaly, right thyroid ima artery, left thyroid ima artery

During the gross anatomy course 27.3 mm distal to its origin. This artery at the Kurume University School of ran downwards for approximately 22.5 mm Medicine in 1995, an anomalous case of and gave off the left thyroid ima artery. double thyroid ima artery was found in The external diameter of the left thyroid a 58-year-old Japanese male cadaver. ima artery was approximately 1.5 mm at A photograph of this case is shown its origin. The artery ran upwards and in Fig. 1 and a schematic illustration in curved medially for approximately Fig. 2. 57.3 mm, and supplied the lower part of The right thyroid ima artery: The right the left lobe of the thyroid gland. internal thoracic artery arose from the The other thyroid : The other right approximately thyroid arteries took fundamentally 57.0 mm distal to the origin of the normal course. The superior thyroid brachiocephalic trunk. This artery ran artery arose from the external carotid downwards for approximately 21.2 mm artery as the first branch of this artery, and gave off the right thyroid ima artery. and supplied the upper part of the The external diameter of the right thyroid gland. thyroid ima artery was approximately The arose 1.9 mm at its origin. This artery ran from the and upwards and curved medially for approx- supplied the middle part of the thyroid imately 59.0 mm, and supplied the lower gland. In this case, the thyrocervical part of the right lobe of the thyroid trunk arose superiorly from the first part gland. of the subclavian artery, and divided into The left thyroid ima artery: The left the inferior thyroid and the superficial internal thoracic artery arose from the cervical arteries. The inferior thyroid left subclavian artery approximately artery first ran upwards, then after

Correspondence to: M. Yoshizuka, M.D., Department of Anatomy, Kurume University School of Medicine, Kurume 830, Japan. Tel: 0942-31-7540, 0942-35-3311 (EXT: 3135) Fax: 0942-33-3233

177 178 SANNOMIYA ET AL.

Fig. 1. A general view of the present case is shown. The right (1A) and the left (1B) thyroid ima arteries originate from the internal thoracic artery of the corresponding side, run upwards and curve medially, and supply the lower part of the thyroid gland. IT: internal thoracic artery; ITA: inferior thyroid artery; LIma: left thyroid ima artery; LSA: left subclavian artery; RCA: right common carotid artery; RIma: right thyroid ima artery; RSA: right subclavian artery; TCT: thyrocervical trunk; Thyr: thyroid gland; VA:

giving off the ascending cervical artery, which supplies the thyroid gland and it turned medially and reached the originates from the aortic arch (Type 1), lateral border of the thyroid gland. the brachiocephalic trunk (Type 2), the It is well known that the arteries common carotid artery (Type 3) or the supplying the thyroid gland are the internal thoracic artery (Type 4). Since superior thyroid from the external the supply to the thyroid gland is carotid artery and the inferior thyroid of great clinical relevance, there have from the thyrocervical trunk, and some- been numerous case reports concerning times the anomalous thyroid ima artery. this artery. Estimated frequencies are The thyroid ima artery is defined and shown in Table 1. classified by Adachi (1928) as the artery However, almost all of the cases of SHORT COMMUNICATION 179

Fig. 2. A diagram of the vessels shown in Fig. 1. AA: aortic arch; ACA: ascending cervical artery; CT: ; DCA: ; HIA: highest intercostal artery; IT: internal thoracic artery; ITA: inferior thyroid artery; LCA: left common carotid artery; L,Ima: left thyroid ima artery; LSA: left subclavian artery; RCA: right common carotid artery; R,Ima: right thyroid ima artery; RSA: right subclavian artery; SCA: superficial cervical artery; SSA: ; TCA: thyrocervical trunk; Thyr: thyroid gland; VA: vertebral artery

thyroid ima artery described in these reports were unilateral. The anomaly of TABLE 1. the right and the left thyroid ima arteries Frequency of thyroid ima artery independently arising from different arteries, as in the present case, is rare. According to Toh et al. (1992b), only ten cases appear in the literature. Niida and Yamasaki (1984) classified this kind of anomaly into three subtypes according to its origin and named this anomaly the double thyroid ima artery (Table 2). The case described in the present report appears to be the eleventh case and belongs to Type 3 of their classification. 180 SANNOMIYA ET AL.

TABLE 2. Number of double thyroid ima artery according to Niida and Yamasaki's Classification

References Kyushu. J Kurume Med Assoc 1955; 18:1128- 1132. (in Japanese) Adachi B. Das Arteriensystem der Japaner. Bd. Niida S, and Yamasaki M. The anatomical 1. Die Kaiserlich Japanische Umversitat zu consideration of the double thyroid ima Kyoto, 1928. artery. Acta Anat Nippon 1984; 59:9-17. (in Fujimoto Y, Suwa F, and Kimura K. A case of Japanese) the left arising from Toh H, Kodama J, and Ohomori T. The the left common carotid artery and the A. anatomical consideration of the thyroidea thyroid ima. Okajima's Folia Anat Jap 1974; ima artery. J Fukuoka Dent Coil 1992a; 51:219-234. 18:448-451. (in Japanese) Hirose K. Uber die A. thyreoidea ima. Jap J Clin Toh H, Tsuno K, Iha Y, and Ohomori T. A rare Exp Med 1931; 8:486-491. (in Japanese) case of double thyroid ima artery. J Fukuoka Mada S, Hisatomi K, Kawahara K, and Matsuo Dent Coil 1992b; 19:33-36. (in Japanese) T. Uber die A. thyreoidea ima des Japaners in

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