Almalali Maryam Isa Ahmed, Takrouni Arwa Omar, Alqattan Abeer Ali, Alsolami Sana, Salman Jasim Maki Jasim, Aljehani Mohammed Maher Mousa, Albaqami Rakan Mohammad J, Alyahyaei Abdulrahman Mohammad, Alrasheed Fathi Aysh Abdullah
General Surgery Department, Dammam Medical Complex, Dammam, 31444, Saudi Arabia.
Radiology Department, Dammam Medical Complex, Dammam, 31444, Saudi Arabia.
Ann Med Surg (Lond). 2022 Jun 23;79:104019. doi: 10.1016/j.amsu.2022.104019. eCollection 2022 Jul.
Hashimoto thyroiditis (HT) is an autoimmune disorder characterized by inadequate thyroid hormone production. A fibrous variant is one of the rarest entities of Hashimoto's thyroiditis disease. A 42 -year-old female patient presented to our service with neck swelling associated with difficulty swallowing; she was discovered to have an enlarged thyroid gland with mass effect. She underwent an ultrasound and fine-needle aspiration (FNA), which was consistent with Hashimoto's thyroiditis -Bethesda category II-. Due to compressive symptoms, we proceeded to total thyroidectomy. The final histopathology revealed numerous polymorphic lymphoid cells, plasma cells, follicular cells, and scattered Hürthle cells, characteristic of fibrous variants. The surgery was complicated with voice hoarseness and hypocalcemia, which was managed successfully with corticosteroids and calcium supplements. The mainline treatment of HT is medical, but surgical intervention can be considered in some cases. A multidisciplinary approach is needed for successful management. Continuous patient monitoring post-operatively is vital to detect and intervene with early surgical complications.
桥本甲状腺炎（HT）是一种自身免疫性疾病，其特征是甲状腺激素分泌不足。纤维性变体是桥本甲状腺炎疾病中最罕见的类型之一。一名42岁女性患者因颈部肿胀伴吞咽困难前来就诊；检查发现她甲状腺肿大并伴有占位效应。她接受了超声检查和细针穿刺活检（FNA），结果与桥本甲状腺炎——贝塞斯达分类II类——相符。由于出现压迫症状，我们对她实施了甲状腺全切除术。最终的组织病理学检查显示有大量多形性淋巴细胞、浆细胞、滤泡细胞以及散在的许特莱细胞，这是纤维性变体的特征。手术出现了声音嘶哑和低钙血症等并发症，通过使用皮质类固醇和补钙得以成功处理。HT的主要治疗方法是药物治疗，但在某些情况下也可考虑手术干预。成功的管理需要多学科方法。术后持续对患者进行监测对于发现并干预早期手术并发症至关重要。
