J Korean Endocr Soc.  2009 Mar;24(1):38-41. 10.3803/jkes.2009.24.1.38.

A Case of Acute Suppurative Thyroiditis in a Patient with Leukemia Who was Treated with Chemotherapy

• Choi HS
• Ahn HY
• Lee JS
• Kim H
• Lim JA
• Kim TH
• Kim M
• Lee Y
• Park DJ
• Cho BY

• KMID: 1468494
• DOI: http://doi.org/10.3803/jkes.2009.24.1.38

Abstract

Acute suppurative thyroiditis (AST) is a rare disease of the thyroid gland that results from anatomical abnormalities, such as pyriform sinus fistula. However, in some case reports, patients with AST did not have anatomical abnormalities, including a report in which children with acute leukemia developed AST after chemotherapy. We report a case of AST in an adult with a hematologic disorder treated with chemotherapy. Although he was initially treated with parenteral antibiotics, surgical intervention was performed due to progressive worsening of AST. He recovered after surgical intervention and had no anatomical abnormality.

Keyword

acute suppurative thyroiditis; chemotherapy; hematologic disorder

MeSH Terms

Adult
Anti-Bacterial Agents
Child
Fistula
Humans
Leukemia
Pyriform Sinus
Rare Diseases
Thyroid Gland
Thyroiditis, Suppurative
Anti-Bacterial Agents

Figure

• 

  Fig. 1 There is a 2.3 × 2.1 cm sized cystic mass lesion with decreased enhancement in right thyroid gland. In left thyroid gland, two small cystic lesions under 0.5 cm are observed. There is no significant lymphadenopathy in cervical lymph nodes. These finding are compatible with abscess on thyroid gland.

• 

  Fig. 2 Microscopy of the excised right lobe displays chronic active inflammation with abscess formation and adenomatous goiter (H&E stain, ×100).

Reference

1. Miyauchi A, Matsuzuka F, Kuma K, Takai S. Piriform sinus fistula: an underlying abnormality common in patients with acute suppurative thyroiditis. World J Surg. 1990. 14:400–405.

2. Yamada H, Fujita K, Tokuriki T, Ishida R. Nine cases of piriform sinus fistula with acute suppurative thyroiditis. Auris Nasus Larynx. 2002. 29:361–365.

3. Yung BC, Loke TK, Fan WC, Chan JC. Acute suppurative thyroiditis due to foreign body-induced retropharyngeal abscess presented as thyrotoxicosis. Clin Nucl Med. 2000. 25:249–252.

4. Nishihara E, Miyauchi A, Matsuzuka F, Sasaki I, Ohye H, Kubota S, Fukata S, Amino N, Kuma K. Acute suppurative thyroiditis after fine-needle aspiration causing thyrotoxicosis. Thyroid. 2005. 15:1183–1187.

5. Da'as N, Lossos IS, Yahalom V, Rund D, Wolf DG, Zelig O, Ben-Yehuda D. Candida abscess of the thyroid in a patient with acute lymphocytic leukemia. Eur J Med Res. 1997. 2:365–366.

6. Falchuk SC, Ahlgren JD, Holt RW. Acute thyroiditis as a complication of chemotherapy administration through a Hickman catheter. Cancer Treat Rep. 1987. 71:788–790.

7. Robinson MF, Forgan-Smith WR, Craswell PW. Candida thyroiditis--treated with 5 fluoro-cytosine. Aust N Z J Med. 1975. 5:472–474.

8. Fernandez JF, Anaissie EJ, Vassilopoulou-Sellin R, Samaan NA. Acute fungal thyroiditis in a patient with acute myelogenous leukaemia. J Intern Med. 1991. 230:539–541.

9. Imai C, Kakihara T, Watanabe A, Ikarashi Y, Hotta H, Tanaka A, Uchiyama M. Acute suppurative thyroiditis as a rare complication of aggressive chemotherapy in children with acute myelogeneous leukemia. Pediatr Hematol Oncol. 2002. 19:247–253.

10. Kim Tae Yong, Yang Han Mo, Hwang Jae Kyung, Cho Young Min, Park Young Joo, Park Do Joon, Kim Seong Yeon, Lee Hong Kyu, Cho Bo Youn. A Case of Acute Suppurative Thyroiditis as a Complication of Acupuncture in Patient with a Benign Thyroid Nodule. J Kor Soc Endocrinol. 2002. 17:576–582.

11. Echevarria Villegas MP, Franco Vicario R, Solano Lopez D, Landin Vicuna R, Teira Cobo R, Miguel de la Villa F. Acute suppurative thyroiditis and Klebsiella pneumoniae sepsis. A case report and review of the literature. Rev Clin Esp. 1992. 190:458–459.

12. Lee KB, Kim NS, Kim BW, Lee JT. A Case of Acute Thyroiditis Complicated in the Course of Paratyphoid Fever. Korean J Med. 1984. 27:1111–1117.

13. Paik Sai Hyun, Lee Jin Goo, You Jae Myung, Choi DS. A case of Acute Supprative Thyroiditis. J Kor Soc Endocrinol. 1991. 6:187–190.

14. Lee Jae Bok, Son Seok Man, Lee Kyoung Seog, Jeong Yeong Tae, Kim In Joo, Kim YK. Two Cases of Tuberculosis of the Thyroid Gland with Euthyroidism. J Kor Soc Endocrinol. 1994. 9:380–384.

15. Choi DH, Soh JB, You KH, Shin BJ, Kim KN, Cho CG. A Case of Acute Suppurative Thyroiditis by Xanthomonas Maltophilia. J Kor Soc Endocrinol. 1995. 10:131–135.

16. Su DH, Huang TS. Acute suppurative thyroiditis caused by Salmonella typhimurium: a case report and review of the literature. Thyroid. 2002. 12:1023–1027.

17. McLaughlin SA, Smith SL, Meek SE. Acute suppurative thyroiditis caused by Pasteurella multocida and associated with thyrotoxicosis. Thyroid. 2006. 16:307–310.

18. Yoo CH, Kim YN, Shon CB, Park EH, Choi YS, Park YH, Kim JH. A case of acute suppurative thyroiditis with thyrotoxicosis. Korean J Med. 2008. 75:242–245.

19. Brook I. Microbiology and management of acute suppurative thyroiditis in children. Int J Pediatr Otorhinolaryngol. 2003. 67:447–451.

20. Lin KD, Lin JD, Huang MJ, Huang HS, Jeng LB, Ho YS. Acute suppurative thyroiditis and aggressive malignant thyroid tumors: differences in clinical presentation. J Surg Oncol. 1998. 67:28–32.