Jung Yiechul J, Schaub Carl R, Rhodes Ronald, Rich Frank A, Muehlenbein Stephen J
Northeastern Ohio Universities College of Medicine, Rootstown, USA.
Endocr Pract. 2004 Nov-Dec;10(6):483-6. doi: 10.4158/EP.10.6.483.
To report a case of Riedel's thyroiditis, which was successfully treated with tamoxifen.
We present the clinical, laboratory, and imaging findings and describe the clinical course of a patient with Riedel's thyroiditis.
A 40-year-old woman presented with hypothyroidism and a large goiter, which was unresponsive to hormone replacement therapy. Magnetic resonance imaging confirmed the presence of an enlarged thyroid gland, more pronounced on the right than on the left. The patient had progressive discomfort attributable to compressive symptoms in the neck. Surgical exploration of the neck disclosed a hard, immobile thyroid mass, which could not be resected because of adherence to surrounding structures. Biopsy of the thyroid and of the muscles of the neck revealed Riedel's thyroiditis. Treatment with tamoxifen, in a dosage of 20 mg twice a day for more than 1(1/2) years, completely resolved the neck mass (substantiated by follow-up magnetic resonance imaging) and relieved the signs and symptoms of compression of the neck.
Tamoxifen treatment is effective in resolving the mass and compression in Riedel's thyroiditis.
报告一例用他莫昔芬成功治疗的Riedel甲状腺炎病例。
我们展示了一名Riedel甲状腺炎患者的临床、实验室及影像学检查结果,并描述其临床病程。
一名40岁女性出现甲状腺功能减退及巨大甲状腺肿,对激素替代治疗无反应。磁共振成像证实甲状腺肿大,右侧比左侧更明显。患者因颈部压迫症状出现进行性不适。颈部手术探查发现一个坚硬、固定的甲状腺肿块,因与周围结构粘连无法切除。甲状腺及颈部肌肉活检显示为Riedel甲状腺炎。给予他莫昔芬治疗,剂量为每日2次,每次20mg,持续超过1.5年,颈部肿块完全消退(随访磁共振成像证实),颈部压迫的体征和症状缓解。
他莫昔芬治疗对消除Riedel甲状腺炎的肿块及压迫有效。