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  • • Rare condition

    • Invasive fibrosis of the thyroid gland

    • Symptoms appear gradually

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Epidemiology

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  • • Extremely rare

    • Usually presents in middle-aged women

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Symptoms and Signs

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  • • Large, nontender, woody mass in the thyroid region

    • Stridor

    • Dysphagia

    • Hoarse voice

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Laboratory Findings

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  • • Biopsy shows marked fibrosis and chronic inflammation

    • Hypothyroid (late stage)

    • Absent or low titers of antithyroid antibodies

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  • • Inflammatory process involves surrounding muscles and causes tracheal compression or esophageal obstruction

    • Etiology is unknown

    • May be associated with fibrosis of other organ systems, such as the retroperitoneum

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Rule Out

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  • • Thyroid carcinoma

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  • • Physical exam

    • Thyroid function tests

    • Cervical ultrasound

    • Fine needle aspiration

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  • • Corticosteroid therapy often requires long-term maintenance therapy

    • Low-dose radiation may be beneficial if corticosteroids or surgery is unsuccessful

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Surgery

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Indications

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  • • Esophageal or tracheal compression

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Medications

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  • • Corticosteroid therapy

    • Thyroid hormone replacement if hypothyroid

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Prognosis

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  • • Multifocal fibrosis may develop in a few patients as many as 10 years after diagnosis with Reidel thyroiditis; this may be life-threatening

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References

Papi G. LiVolsi VA. Current concepts on Riedel thyroiditis. American Journal of Clinical Pathology. 2004 121 Suppl:S50-63.

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