Inflammation of the thyroid gland is called thyroiditis. Thyroiditis is a condition classified by the way they affect thyroid function or whether they are painful. Thyroiditis types can be determined by evaluating the patient’s symptoms, changes in thyroid functions, presence of familial history, rapid or slow progression of the picture, pain in the neck or whether there is an enlarged thyroid gland.
Riedel’s thyroiditis can also be called Riedel’s struma or chronic invasive fibrous thyroiditis in different texts. It is a picture that causes symptoms such as hoarseness and difficulty in swallowing by keeping the thyroid gland and surrounding structures in a fibrotic structure. It is a condition in which the thyroid gland is hard as a board. It often causes hypothyroidism.
The fibrotic structure of Riedel’s thyroiditis can sometimes enlarge and invade the surrounding tissues. It can cause shortness of breath by affecting the trachea. It can cause hoarseness by affecting the laryngeal nerves. It can also invade surrounding muscles and vessels. Phlebitis may develop as a result of invasion of the vessels. It is characterized by hard woody thyroid tissue that invades the thyroid gland and surrounding tissues. It is a very rare disease. The reason is not known exactly.
In Riedel’s thyroiditis, the trachea remains motionless during swallowing. The thyroid gland can be palpated. If the parathyroid glands behind the thyroid gland are also involved, the patient may also experience symptoms of hypoparathyroidism.
Since Riedel’s thyroiditis spreads to the surrounding tissues, it should be differentiated from similar invasive cancers. Infiltrative thyroid cancers such as anaplastic thyroid carcinoma, thyroid lymphoma and thyroid sarcoma should be investigated in detail.
Diagnosis of Riedel’s thyroiditis:
The presence of a hard, wooden-like immobile thyroid gland in physical examination, and the presence of a dysfunctional thyroid gland with decreased blood supply in ultrasonography are important. Hiodens mass appearance can be detected by computed tomography. Contrast material cannot enter the thyroid gland and the contrast-enhanced area cannot be seen. PET can be helpful. Samples may not be obtained with fine-needle aspiration biopsy. Definitive diagnosis is made only by biopsy.
Treatment of Riedel’s thyroiditis:
Glucocorticoids are the most commonly used drug therapy for Riedel’s thyroiditis. It can be useful in the early period. It may not be effective in advanced cases. If hypothyroidism has developed, thyroid hormone replacement is performed.
Tamoxifen can also be used with glucorticoids to slow fibrosis.
Surgical treatment is partially effective due to the fibrotic nature and margins of Riedel’s thyroiditis. Complications of surgical treatment are more common. Minimal surgical methods are more preferred to reduce compression symptoms.
Riedel’s thyroiditis is a disease that takes a long time to diagnose. It can remain stable for many years. It’s usually good looking. Rarely, exacerbations may occur. Compression of the trachea is a rare cause of death.