Riedel’s thyroiditis and fibrous variant of Hashimoto’s thyroiditis: A clinicopathological and immunohistochemical study

Papi, Giampaolo; Corrado, Stefania; Carapezzi, C; Gaetani, C. De; Carani, Cesare

doi:10.1007/bf03345200

Cited by 34 publications

(23 citation statements)

References 14 publications

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“…Although the fibrous variant of HT is among the differential diagnosis of RT as there are clear-cut differences between them, there are a few reports suggesting that RT is a variant of HT or it may follow HT; these may also coexist [8,10,[16][17][18].…”

Section: Discussionmentioning

confidence: 96%

A case of Riedel’s thyroiditis with pleural and pericardial effusions

Erdoğan

Anıl

Türkçapar

et al. 2009

Endocr

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Riedel's thyroiditis (RT) is a rare type of chronic thyroiditis of unproven etiology and definite treatment. It can be associated with retroperitoneal, mediastinal, orbital, and hepatic fibrosis. Symptoms arise mainly due to compression of neighboring structures. Surgery is usually required for a definite diagnosis and decompression to relieve the symptoms. Glucocorticoids and tamoxifen are commonly used agents for the pharmacotherapy. We hereby describe the development of pleural and pericardial effusions during the clinical course of an RT case. A 39-year-old woman suffering from neck compression symptoms was admitted to the hospital. After a decompression isthmectomy, RT was diagnosed. She responded well to glucocorticoid therapy after surgery. However, symptoms reoccurred shortly after glucocorticoid withdrawal and the disease process extended to the mediastinum. Tamoxifen was started and the neck and mediastinal mass regressed and her symptoms disappeared considerably for more than 6 months. However, she was readmitted with severe dyspnea and chest pain. Further investigation revealed an exudative pleural and pericardial effusion and mediastinal enlargement. A thorough evaluation of the patient's effusions did not disclose any specific etiological insult. The patient was symptom-free with a considerable reduction of the soft tissue mass and no effusions, and treated successfully with colchicine, azathioprine, and glucocorticoids. To the best of our knowledge, this is the first case reported in the literature as an RT presenting with pleuropericardial effusions.

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Section: Discussionmentioning

confidence: 96%

A case of Riedel’s thyroiditis with pleural and pericardial effusions

Erdoğan

Anıl

Türkçapar

et al. 2009

Endocr

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“…In the absence of proper evidence, it has to be treated similar to thyroid cancer without HT. Various subtypes of HT have been described [23], although their clinical implication is an enigma. Technically, our surgical experience with the operated cases of HT taught us that an HT-afflicted thyroid is easier to handle and retract due to firm rubbery consistency, especially in diffuse goiter with better visualisation of vascular pedicles.…”

Section: Discussionmentioning

confidence: 99%

Surgical Indications for Goiter with Background Hashimoto’s Thyroiditis: Institutional Experience

Bhargav

Shekhar

2011

Indian J Surg

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Hashimoto's thyroiditis (HT) is usually treated conservatively with thyroxine. Its incidence is higher in Iodine sufficient areas and may require surgery for associated nodularity or complications. A retrospective study on surgically treated HT cases was conducted in a teritiary care teaching hospital in an Iodine sufficient area of Southern India. 34 cases of goiter with associated HT, who underwent thyroidectomy between 2007 and 2010 were analysed for indications of surgery. Minimum followup period was 6 months. F:M ratio was 31:3 with mean age of 41.3 years. Goiter was diffuse in 41% and nodular in 59%. 16 (47%) of patients were hypothyroid. Autoimmune association was found in 35%. Commonest surgery done was hemithyroidectomy in 12 (35%) followed by subtotal thyroidectomy in 10 cases. Most frequent indication for surgery was nodular goiter in 12 (35%) followed by associated malignancy, persistent goiter, pressure symptoms and painful thyroiditis. Histopathology showed diffuse HT alone in 12 (35%) and rest of the cases had HT as a component synchronous with other pathologies. Associated pathologies were benign multinodular goiter (6), colloid nodule (6), papillary cancer (5), follicular adenoma (4), cyst (1). Surgery for HT is primarily indicated for associated pathologies like dominant nodule, suspicious or proven malignancy, persistent goiter, painful thyroiditis, pressure symptoms and rarely for HT perse. Rate of surgery for HT associated goiter appears to be higher in Iodine sufficient areas, the cause of which needs to be studied further.

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“…The progressive fibrous replacement of thyroid tissue results in early hypothyroidism of the primarily often euthyroid patients. Diagnostically, the typically prevailing findings are a pronounced hypoechoic gland on ultrasound with the absence of vascular flow, a diminished uptake with a cold appearance on TC 99 -scintigraphy, hypointensity in T1 and T2-weighted MRI and fibrous tissue fragments and moderate cellularity with inflammatory cells on fine needle aspiration [5,6]. Laboratory findings may reveal elevation of leucocytes and erythrocyte sedimentation rate.…”

Section: Introductionmentioning

confidence: 95%