A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel’s Thyroiditis
A 44-year-old female presented with a two-month history of a neck mass, sore throat, hoarseness, and intermittent dysphagia. Examination revealed a “woody” hard swelling arising from the right lobe of the thyroid. Clinically this was felt to be classical Riedel’s thyroiditis (RT). Thyroid ultrasound...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2015/686085 |
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| author | Jennifer Walsh Tomas P. Griffin Carmel B. Ryan James Fitzgibbon Patrick Sheahan Matthew S. Murphy |
| author_facet | Jennifer Walsh Tomas P. Griffin Carmel B. Ryan James Fitzgibbon Patrick Sheahan Matthew S. Murphy |
| author_sort | Jennifer Walsh |
| collection | DOAJ |
| description | A 44-year-old female presented with a two-month history of a neck mass, sore throat, hoarseness, and intermittent dysphagia. Examination revealed a “woody” hard swelling arising from the right lobe of the thyroid. Clinically this was felt to be classical Riedel’s thyroiditis (RT). Thyroid ultrasound showed a diffusely enlarged, low echogenicity thyroid with a multinodular goitre. An abnormal nodule extending across the isthmus was noted. Following a nondiagnostic fine needle aspiration, an open core biopsy was performed. This showed dense sclerotic fibrosis punctuated by nodular mononuclear inflammatory cells, which obscured follicular epithelial cells consistent with a fibrosing thyroiditis (Riedel’s thyroiditis). A biopsy of pretracheal lymph nodes showed a sclerotic process throughout the lymph nodes and nests of epithelium bands with squamous differentiation obscured by a fibrous process. These findings raised the differential diagnosis of diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) with metastasis to lymph nodes. A total thyroidectomy and pretracheal lymph node dissection were performed. The final histological diagnosis was DSV-PTC. When managing a patient with presumed RT it is important to consider malignancy in the differential. DSV-PTC is one of the more aggressive forms of thyroid cancer but with early diagnosis and appropriate treatment patients may have excellent outcomes. |
| format | Article |
| id | doaj-art-38e06dbb6703421b9137acd8fb89a870 |
| institution | Kabale University |
| issn | 2090-6501 2090-651X |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Endocrinology |
| spelling | doaj-art-38e06dbb6703421b9137acd8fb89a8702025-02-03T06:01:11ZengWileyCase Reports in Endocrinology2090-65012090-651X2015-01-01201510.1155/2015/686085686085A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel’s ThyroiditisJennifer Walsh0Tomas P. Griffin1Carmel B. Ryan2James Fitzgibbon3Patrick Sheahan4Matthew S. Murphy5Department of Endocrinology, South Infirmary Victoria University Hospital, Cork, IrelandDepartment of Endocrinology, South Infirmary Victoria University Hospital, Cork, IrelandDepartment of Pathology, Cork University Hospital, Cork, IrelandDepartment of Pathology, Cork University Hospital, Cork, IrelandDepartment of Otolaryngology-Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, IrelandDepartment of Endocrinology, South Infirmary Victoria University Hospital, Cork, IrelandA 44-year-old female presented with a two-month history of a neck mass, sore throat, hoarseness, and intermittent dysphagia. Examination revealed a “woody” hard swelling arising from the right lobe of the thyroid. Clinically this was felt to be classical Riedel’s thyroiditis (RT). Thyroid ultrasound showed a diffusely enlarged, low echogenicity thyroid with a multinodular goitre. An abnormal nodule extending across the isthmus was noted. Following a nondiagnostic fine needle aspiration, an open core biopsy was performed. This showed dense sclerotic fibrosis punctuated by nodular mononuclear inflammatory cells, which obscured follicular epithelial cells consistent with a fibrosing thyroiditis (Riedel’s thyroiditis). A biopsy of pretracheal lymph nodes showed a sclerotic process throughout the lymph nodes and nests of epithelium bands with squamous differentiation obscured by a fibrous process. These findings raised the differential diagnosis of diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) with metastasis to lymph nodes. A total thyroidectomy and pretracheal lymph node dissection were performed. The final histological diagnosis was DSV-PTC. When managing a patient with presumed RT it is important to consider malignancy in the differential. DSV-PTC is one of the more aggressive forms of thyroid cancer but with early diagnosis and appropriate treatment patients may have excellent outcomes.http://dx.doi.org/10.1155/2015/686085 |
| spellingShingle | Jennifer Walsh Tomas P. Griffin Carmel B. Ryan James Fitzgibbon Patrick Sheahan Matthew S. Murphy A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel’s Thyroiditis Case Reports in Endocrinology |
| title | A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel’s Thyroiditis |
| title_full | A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel’s Thyroiditis |
| title_fullStr | A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel’s Thyroiditis |
| title_full_unstemmed | A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel’s Thyroiditis |
| title_short | A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel’s Thyroiditis |
| title_sort | case report demonstrating how the clinical presentation of the diffuse sclerosing variant of papillary thyroid carcinoma can mimic benign riedel s thyroiditis |
| url | http://dx.doi.org/10.1155/2015/686085 |
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