Surgical Treatment for Riedel's Thyroiditis: a Case Report

ABSTRACT

Riedel's thyroiditis is a rare fibrotic condition that results in the destruction of the thyroid and infiltration into surrounding tissues. The exact etiology is not yet clear, although systemic fibrosing disorder, a variant of Hashimoto's thyroiditis, a primary inflammatory disorder of the thyroid, and even a manifestation of end-stage subacute thyroiditis has been suggested. Although various treatments have been applied, no definitive treatment has yet been established. We report a case of Riedel's thyroiditis treated without complications using microscopic surgery. A 54-year-old man visited our clinic presenting with neck tightness and a left neck mass. A gun biopsy revealed a benign thyroid mass, although the radiologic findings showed a malignant thyroid tumor with invasion into the trachea and strap muscles. The patient underwent a left hemi-thyroidectomy and shaving of the trachea, esophagus and recurrent laryngeal nerve under microscopy. The final pathology revealed Riedel's thyroiditis combined with Hashimoto's thyroiditis. The patient had symptomatic relief without vocal fold paralysis and hypocalcemia. Surgical treatment using microscopic dissection can be considered to be one of treatment option for Riedel's thyroiditis.