Een harde schildkliermassa is niet altijd maligne

Abstract

A hard thyroid mass: not always a malignancy In this article, the medical history of a patient with a hard mass at the thyroid and hyperthyroidism secondary to Riedel’s thyroiditis is presented. This case report shows an unusual course with a relapse, until know described in only 4 other published case reports. Riedel’s thyroiditis, also known as Riedel’s struma, is a rare invasive fibrous thyroiditis with a prevalence of 1 per 100,000 people and a male to female ratio of 1/4. Classically, it presents as a stone-like, non-tender thyroid mass with obstructive symptoms such as dyspnea, dysphagia and hoarseness as the structures surrounding the thyroid are involved. Its aetiology is unknown, but it is suggested to be part of a systemic fibrosing disorder. Thyroid dysfunction is possible, mainly hypothyroidism secondary to invasion of the normal thyroid tissue. Ultrasound findings cannot differentiate with anaplastic thyroid carcinoma, a malignancy with an unfavourable prognosis. The diagnosis is based on biopsy findings and the presence of extrathyroidal expansion of the mass. There is no standardized treatment for Riedel’s thyroiditis due to the rarity of the disease. Glucocorticoids are the mainstay of the medical treatment. Surgery is indicated only to relieve compressive symptoms.