Reidel's Thyroiditis
Findings:
Multiple axial noncontrast neck CT images show a poorly defined infiltrative process centered on the left thyroid lobe, associated with mild tracheal displacement and encasement/invasion of multiple adjacent muscular and neurovascular structures.
Differential Diagnosis:
Rediel's thyroiditis, anaplastic thyroid cancer, neck soft tissue sarcoma, metastasis.
Discussion:
nImaging cannot reliably distiguish from anaplastic thyroid cancer- exceedingly rare- autoimmune vs. primary fibrotic- painless hard goiter (sim to anaplastic cancer)
nDense fibrotic process invades adjacent structures- “woody” or “stony” clinical consistency
n1/3 have other “fibroses”- mediastinal, retroperitoneal, primary sclerosing cholangitis
nDiagnosis needs open biopsy with large amount of tissue and close clinicopathologic correlation, FNA will simulate anaplastic Ca
nMortality more from extracervical manifestations, may respond to steroids +/- chemo (tamoxifen)
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