title: A misdiagnosed Riedel's thyroiditis successfully treated by thyroidectomy and tamoxifen.
abstract: Riedel's thyroiditis, known as invasive fibrous thyroiditis, is a very rare form of chronic thyroiditis. It is hard to make the diagnosis without surgical biopsy. We present a case of Riedel's thyroiditis in a 52-year-old female with past history of Hashimoto's thyroiditis. She suffered from bilateral neck pain, which radiated to both lower jaws. The erythrocyte sedimentation rate was 125 mm/hour. Subacute thyroiditis superimposed on Hashimoto's thyroiditis was diagnosed and treated with steroid. However the response was poor and she had a history of severe peptic ulcer. To avoid inducing the peptic ulcer by steroid, she received bilateral subtotal thyroidectomy. During surgery, the thyroid had severe adhesion to surrounding soft tissue and the pathology showed Riedel's thyroiditis. The neck pain improved after thyroidectomy. Tamoxifen has been given for 8 months and the size of remnant thyroid decreased to 8 mm. We concluded that combined thyroidectomy and tamoxifen successfully cured a patient with Riedel's thyroiditis.
authors.affiliation: Department of Surgery of Dou-liou Branch, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan.
authors.forename: Chih-Jung
authors.initials: CJ
authors.lastname: Wang
authors.forename: Ta-Jen
authors.initials: TJ
authors.lastname: Wu
authors.forename: Chung-Ta
authors.initials: CT
authors.lastname: Lee
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Huang
mesh_terms: D002908:Chronic Disease; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008875:Middle Aged; D013629:Tamoxifen / Q000627:therapeutic use; D013965:Thyroidectomy; D013966:Thyroiditis / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D016212:Transforming Growth Factor beta / Q000187:drug effects
chemical_list: D016212:Transforming Growth Factor beta; D013629:Tamoxifen