Riedel’s thyroiditis — difficulties in differentiating from thyroid cancer

Résumé : La thyroïdite de Riedel est une pathologie fibrosante rare qui s’associe parfois à d’autres pathologies fibrosantes comme rapporté dans l’observation qui suit. Observation : Mme B.F consulte à l’âge de 44 ans pour un goitre de consistance dure pierreuse suspecte ; l’échographie cervicale retrouve un goitre nodulaire calcifié suspect avec des adénopathies satellites, la cytoponction retrouva une hyperplasie lymphoréticulaire non spécifique. La patiente a été opérée retrouvant une thyroïde infiltrant les muscles préthyroïdiens ; les biopsies avec l’étude histologique étaient en faveur d’une thyroïdite de Riedel, la patiente développa par la suite une hypothyroïdie qui fut substituée. Six années plus tard, la patiente développa une toux et un syndrome cave supérieur, le scanner thoracique retrouva un aspect de fibrose médiastinale, la patiente a été mise sous corticoïdes avec une bonne évolution clinique et une stabilisation des lésions sur le plan radiologique. Par la suite, après plusieurs années et suite à des douleurs lombaires droites l’IRM abdominale retrouva une fibrose rétropéritonéale engainant l’uretère droit. Conclusion : La thyroïdite de Riedel s’intègre parfois dans une atteinte fibrosante multi systémique qu’il faudrait rechercher et traiter afin d’améliorer le pronostic du patient.

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Riedel's thyroiditis: diagnostic difficulties (clinical case and brief review)

Medical Council ◽

10.21518/2079-701x-2021-7-166-171 ◽

2021 ◽

pp. 166-171

Author(s):

A. A. Rybakova ◽

N. M. Platonova ◽

T. V. Soldatova ◽

N. V. Tarbaeva ◽

T. S. Panevin ◽

...

Keyword(s):

Drug Therapy ◽

Clinical Case ◽

Clinical Performance ◽

Fine Needle Biopsy ◽

Morphological Description ◽

Positive Trend ◽

Riedel’S Thyroiditis ◽

Compression Syndrome ◽

Diagnostic Difficulties ◽

Riedel's Thyroiditis

Riedel's thyroiditis is a rare disease characterized by chronic fibrosis. Clinical performance of this disease is dense stony goiter, which can poorly be displaced during palpation. The overgrowth of the goiter can lead to the development of compression syndrome. To diagnose we need to made fine needle biopsy and made the final diagnose according to its results or according to the morphological description of the postoperative material. An important step in the diagnosis of Riedel's thyroiditis is the determination of serum IgG and IgG4 to exclude an IgG4-associated disease. Treatment of this disease includes drug therapy, which is based on glucocorticosteroids administration or surgical treatment when develops compression syndrome. This article presents a clinical case of a patient with Riedel's thyroiditis; the main complaints were associated with the growth of goiter and the development of compression syndrome. In this regard, patient underwent surgery on the thyroid gland, and after this we get final diagnose. Due to feeling unwell, drug therapy with glucocorticosteroids was prescribed, against the background of which we noted a positive trend.

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IgG4-Related Retroperitoneal Fibrosis: A Rare Association With Riedel’s Thyroiditis

Cureus ◽

10.7759/cureus.13997 ◽

2021 ◽

Author(s):

Jonathan C Pacella ◽

Soamsiri Niwattisaiwong ◽

David Newman

Keyword(s):

Retroperitoneal Fibrosis ◽

Riedel’S Thyroiditis ◽

Rare Association ◽

Riedel's Thyroiditis

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Riedel's Thyroiditis Within an Elderly Patient Revealed by Tracheal Compression: A Case of Report

10.21203/rs.3.rs-78176/v1 ◽

2020 ◽

Author(s):

Zie Ahmed Cheick Traore ◽

N'guiessan Alphonse Aman ◽

Zana Ismael Coulibaly ◽

Kouadio Donatien Koffi ◽

Ibrahiman Toure ◽

...

Keyword(s):

Thyroid Tissue ◽

The Elderly ◽

University Hospital ◽

Screening Methods ◽

Riedel’S Thyroiditis ◽

Case Presentation ◽

Tracheal Compression ◽

Thyroid Mass ◽

Surgery Department ◽

Riedel's Thyroiditis

Abstract Background : Riedel's thyroiditis (RT) is a rare fibrosclerotic disease that affects the thyroid gland and surrounding tissues. The etiology is unknown, and it rarely affects the elderly.Case Presentation : A 56-year-old man, with no particular medical history, was seen in consultation at the Surgery Department of the Treichville Teaching University Hospital for a painless swelling of the anterior base of the neck. Physical examination showed a patient with inspiratory dyspnea probably due to tracheal compression. The patient underwent a subtotal thyroidectomy because of the clinical symptomatology and the persistence of dyspnea. Macroscopically, the thyroid mass was well-encapsulated, weighed 80g, and measured 10 cm x 5 cm x 2 cm. After section, we observed whitish fibrous nodules associated with pinkish-brownish band. Histologically, the architecture of thyroid tissue was restructured by dense and diffuse collagenous fibrosis in which rare atrophic thyroid vesicles were found. The fibrous areas were infiltrated by inflammatory elements, including lymphocytes, plasmocytes, and eosinophilic polynuclear cells. No malignant cells were found. Masson's trichrome staining confirmed the fibrous nature of the thyroid tissue, which is essential for the certain diagnosis of Riedel's thyroiditis. There was no postoperative complication Conclusion: Riedel's thyroiditis is a rare disease that is difficult to diagnose preoperatively despite advances in imaging and fine needle cytology screening methods. Histological examination of the sample confirms the diagnosis of Riedel's thyroiditis. Thyroidectomy is indicated in patients with compression symptoms. Clinicians should suspect Riedel's thyroiditis in patients with a hard thyroid mass with compressive symptoms, despite its rarity.

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