Shafi Alam Ara, Saad Nourah Bin, AlHarthi Bandar
King Fahad Medical City, Makkah Road, Riyadh, 11525, Saudi Arabia.
Ann Med Surg (Lond). 2020 Feb 25;52:5-9. doi: 10.1016/j.amsu.2020.02.006. eCollection 2020 Apr.
Riedel's thyroiditis is a rare inflammatory process which not only involves thyroid gland but also the surrounding vital structures. It may also be associated with various forms of systemic fibrotic disorders. The exact etiology is not known, but currently, the most favored view is that of a localized form of the systemic fibrotic process. We report a case of Riedel's thyroiditis in a male patient, highlighting diagnostic challenges and a rare presentation of hypocalcemia and mimicking thyroid lymphoma. Clinical knowledge of such a presentation of Riedel's thyroiditis would enhance our ability to make a speedy diagnosis. Apart from avoiding aggressive surgical intervention, awareness of such a clinical entity may avoid complications and hence morbidity. Our case also highlights the difficulty in histological diagnosis which is vital to rule out malignancy and avoiding any major surgical intervention fraught with complications. Although the patient had a poor tolerance to Tamoxifen and Rituximab, however, his response to high dose steroids is the currently accepted treatment of choice. This case adds to the sparse literature available on the cytological diagnosis of RT and highlights the diagnostic challenge due to suspicious radiology findings.
里德尔甲状腺炎是一种罕见的炎症过程，不仅累及甲状腺，还累及周围重要结构。它也可能与各种形式的系统性纤维化疾病相关。确切病因尚不清楚，但目前，最受青睐的观点是它是系统性纤维化过程的一种局部形式。我们报告一例男性里德尔甲状腺炎病例，强调诊断挑战以及低钙血症的罕见表现和类似甲状腺淋巴瘤的情况。了解里德尔甲状腺炎的这种表现的临床知识将提高我们快速诊断的能力。除了避免激进的手术干预外，认识到这种临床实体可避免并发症及由此导致的发病率。我们的病例还突出了组织学诊断的困难，这对于排除恶性肿瘤和避免任何充满并发症的重大手术干预至关重要。尽管患者对他莫昔芬和利妥昔单抗耐受性差，然而，他对高剂量类固醇的反应是目前公认的治疗选择。该病例补充了关于里德尔甲状腺炎细胞学诊断的稀少文献，并突出了可疑放射学结果导致的诊断挑战。
