Résumé
This is the first case report about acute suppurative thyroiditis with thyrotoxicosis and pyriform sinus in Korea. A female patient, who was previously healthy, visited our hospital for the treatment of common cold symptoms and neck pain which developed 2 weeks before the visit. The condition of the patient did not improve through the use of antipyretics and even worsened. The patient was admitted to the hospital and was diagnosed with acute suppurative thyroiditis. The culture result of the drained fluid revealed group D Streptococcus. The patients condition was improved after using antibiotics and drainage. After recovery from acute thyroiditis, esophagography was performed and the pyriform sinus was found to be obliterated by chemical cauterization. It is very important yet difficult to differentiate acute thyroiditis with thyrotoxicosis from subacute thyroiditis. In this study, we discussed the differential diagnosis between acute thyroiditis and subacute thyroiditis with a review of literature.
Sujets)
Femelle , Humains , Antibactériens , Antipyrétiques , Cautérisation , Rhume banal , Diagnostic différentiel , Drainage , Fistule , Corée , Cervicalgie , Sinus piriforme , Streptococcus , Glande thyroide , Thyroïdite , Thyroïdite subaigüe , Thyroïdite suppurée , ThyréotoxicoseRésumé
Metastatic thyroid cancer is uncommon but must be distinguished from primary thyroid cancer because of the differences in management and prognosis. Although renal cell carcinoma is one of the most common tumors that metastasize to the thyroid gland, such a case has never been reported in Korea. We describe the first case of metastatic renal cell carcinoma in the thyroid gland. A 66-year-old man presented with a neck mass detected about 6 weeks previously. He had undergone left nephrectomy due to renal cell carcinoma 8 years before and had remained disease-free thereafter. Computed tomography of the neck showed a 5 cm-sized thyroid mass. Fine needle aspiration cytology revealed some malignant cells containing intranuclear inclusions which were assumed to be papillary thyroid carcinoma. The patient underwent total thyroidectomy. Histologic diagnosis of the thyroid mass was metastatic renal cell carcinoma and further evaluation with chest computed tomography showed two enlarged mediastinal lymph nodes suggesting metastases. The previous history of malignancy should be scrutinized when managing a thyroid mass in patients with a prior or concomitant malignancy, and the possibility of metastasis should be carefully considered.