Endocrinol Metab.  2013 Jun;28(2):138-143. 10.3803/EnM.2013.28.2.138.

Riedel Thyroiditis in a Patient with Graves Disease

• Lee DY
• Moon JS
• Kim GE
• Kim HK
• Kang HC

• KMID: 1973813
• DOI: http://doi.org/10.3803/EnM.2013.28.2.138

Abstract

Riedel's thyroiditis is a rare form of infiltrative and inflammatory disease of the thyroid gland and can be associated with systemic fibrotic processes, Hashimoto thyroiditis and Graves disease. Riedel thyroiditis in combination with Graves disease however, is very rare. A 57-year-old woman with a past medical history significant for Graves disease diagnosed 30 years ago presented with an enlarging neck mass and voice changes. Due to suspicion of malignancy, thyroidectomy was performed. Histopathologic examination revealed Riedel thyroiditis. To our knowledge, the association of Riedel thyroiditis with Graves disease has not yet been reported in our country. Here we report a patient with Riedel thyroiditis evolved from antecedent Graves disease.

Keyword

Graves disease; Riedel thyroiditis

MeSH Terms

Female
Graves Disease
Hashimoto Disease
Humans
Neck
Thyroid Gland
Thyroidectomy
Thyroiditis
Voice

Figure

• 

  Fig. 1 Gross appearance of the neck. A very hard, fixed nodule is seen in the right side of the neck.

• 

  Fig. 2 Panoramic ultrasonographic view of the thyroid. A large, heterogeneously echoic mass is seen in the right lobe of the thyroid.

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  Fig. 3 A hypodense mass with scattered internal dense calcifications is evident in a postcontrast study.

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  Fig. 4 Neck computed tomography showed abnormal configuration of the right vocal cord, suggestive of vocal cord paralysis.

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  Fig. 5 (A) Enlarged right lobe of the thyroid with calcification. (B) Extensively hyalinized fibrous tissue replaced the thyroid gland. Fibrosis and inflammation extended beyond the thyroid capsule (H&E stain, ×100). (C) Medium-sized veins encased by fibrosis indicating inflammation of their walls. The inflammation is of the monocuclear type, with a predominance of lymphocytes (H&E stain, ×400).

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