van Schaik Jan, Dekkers Olaf M, van der Kleij-Corssmit Eleonora P M, Romijn Johannes A, Morreau Hans, van de Velde Cornelis J H
Department of Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
Case Rep Med. 2011;2011:349756. doi: 10.1155/2011/349756. Epub 2011 Feb 6.
Painful thyroid has a limited differential diagnosis. In rare cases, no clear cause can be found after careful clinical, biochemical, and radiological analysis. This may lead to extensive patient morbidity and frustration when symptomatic treatment proves insufficient. Hemithyroidectomy or total thyroidectomy may then be the last resort for doctor and patient. Three cases of unexplained painful thyroid which were successfully treated with hemi or total thyroidectomy are presented. In two cases extensive histological evaluation did not yield a satisfactory explanation for the extreme thyroid pain. In one case histological evaluation of the thyroid revealed Hashimoto's thyroiditis. Review of the literature does not mention surgical treatment for unexplained painful thyroid, and only 15 cases of surgical treatment for painful Hashimoto's thyroiditis are presented. Surgical therapy is a successful final option in the treatment of unexplained painful thyroid and painful Hashimoto's thyroiditis.
疼痛性甲状腺疾病的鉴别诊断范围有限。在罕见情况下，经过仔细的临床、生化和放射学分析后仍找不到明确病因。当对症治疗效果不佳时，这可能会给患者带来严重的病痛和挫败感。此时，半甲状腺切除术或全甲状腺切除术可能成为医生和患者的最后选择。本文介绍了3例原因不明的疼痛性甲状腺疾病患者，经半甲状腺切除术或全甲状腺切除术成功治愈。其中2例患者经过广泛的组织学评估，仍无法对甲状腺剧痛给出令人满意的解释。1例患者的甲状腺组织学评估显示为桥本甲状腺炎。文献回顾未提及对原因不明的疼痛性甲状腺疾病进行手术治疗的相关内容，仅报道了15例针对疼痛性桥本甲状腺炎的手术治疗案例。手术治疗是治疗原因不明的疼痛性甲状腺疾病和疼痛性桥本甲状腺炎的一种成功的最终选择。
