Epidermoid cyst abscess of the neck masquerading as a thyroid abscess

Author:

Chatchomchaun Waralee1,Thewjitcharoen Yotsapon1,Krittadhee Karndumri1,Veerasomboonsin Veekij1,Nakasatien Soontaree1,Krittiyawong Sirinate1,Porramatikul Sriurai1,Wanathayanoroj Ekgaluck1,Kanchanapituk Auchai1,Junyangdikul Pairoj2,Himathongkam Thep1

Affiliation:

1. 1Diabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand

2. 2Department of Pathology, Samitivej Srinakarin Hospital, Bangkok Hospital Group, Bangkok, Thailand

Abstract

Summary In this case report, we describe a 37-year-old male who presented with fever and tender neck mass. Neck ultrasonography revealed a mixed echogenic multiloculated solid-cystic lesion containing turbid fluid and occupying the right thyroid region. Thyroid function tests showed subclinical hyperthyroidism. The patient was initially diagnosed with thyroid abscess and he was subsequently treated with percutaneous aspiration and i.v. antibiotics; however, his clinical symptoms did not improve. Surgical treatment was then performed and a pathological examination revealed a ruptured epidermoid cyst with abscess formation. No thyroid tissue was identified in the specimen. The patient was discharged uneventfully. However, at the 3-month and 1-year follow-ups, the patient was discovered to have developed subclinical hypothyroidism. Neck ultrasonography revealed a normal thyroid gland. This report demonstrates a rare case of epidermoid cyst abscess in the cervical region, of which initial imaging and abnormal thyroid function tests led to the erroneous diagnosis of thyroid abscess. Learning points: Epidermoid cyst abscess at the cervical region can mimic thyroid abscess. Neck ultrasonography cannot distinguish thyroid abscess from epidermoid cyst abscess. Thyroid function may be altered due to the adjacent soft tissue inflammation.

Publisher

Bioscientifica

Subject

Endocrinology, Diabetes and Metabolism,Internal Medicine

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