open access

Vol 63, No 2 (2012)
Case report
Published online: 2012-04-27
Submitted: 2013-02-15
Get Citation

What might cause pain in the thyroid gland? Report of a patient with subacute thyroiditis of atypical presentation

Ewelina Szczepanek-Parulska, Ariadna Zybek, Maciej Biczysko, Przemysław Majewski, Marek Ruchała
Endokrynologia Polska 2012;63(2):138-142.

open access

Vol 63, No 2 (2012)
Case report
Published online: 2012-04-27
Submitted: 2013-02-15

Abstract

Subacute granulomatous thyroiditis (SAT), also known as de Quervain’s thyroiditis or painful subacute thyroiditis, is the commonest thyroid condition responsible for neck tenderness. Other causes of pain in the thyroid gland should be taken into consideration during differential diagnosis, especially when a patient presents with misleading or equivocal signs and symptoms. We report the case of a 39 year-old woman diagnosed as having SAT whose clinical, biochemical and radiological presentation varied significantly from the common SAT manifestation. A tentative diagnosis of SAT was made based on the presented symptoms, ultrasonography and fine-needle biopsy results. However, biochemical analysis suggested neither inflammatory process nor the presence of thyrotoxicosis. Moreover, technetium scan of the thyroid revealed normal uptake of the isotope and there was neither clinical nor ultasonographic response for corticosteroids. The patient’s symptoms, despite being prescribed typical treatment, gradually deteriorated and the pain became increasingly debilitating. Eventually, the patient underwent total thyroidectomy. As a result, she has become free of symptoms, but the macroscopic picture of thyroid gland, noted during the operation, gave a suspicion of neoplastic process. Nevertheless, histological study of flow samples confirmed the tentative diagnosis of de Quervain’s thyroiditis, despite all previous findings that were not suggestive of it. This report confirms the likelihood that SAT can present atypically. Additionally, it indicates that surgical treatment may be considered in patients with severe, debilitating, persistent thyroid gland pain connected with SAT clinical course. (Pol J Endocrinol 2012; 63 (2): 138–142)

Abstract

Subacute granulomatous thyroiditis (SAT), also known as de Quervain’s thyroiditis or painful subacute thyroiditis, is the commonest thyroid condition responsible for neck tenderness. Other causes of pain in the thyroid gland should be taken into consideration during differential diagnosis, especially when a patient presents with misleading or equivocal signs and symptoms. We report the case of a 39 year-old woman diagnosed as having SAT whose clinical, biochemical and radiological presentation varied significantly from the common SAT manifestation. A tentative diagnosis of SAT was made based on the presented symptoms, ultrasonography and fine-needle biopsy results. However, biochemical analysis suggested neither inflammatory process nor the presence of thyrotoxicosis. Moreover, technetium scan of the thyroid revealed normal uptake of the isotope and there was neither clinical nor ultasonographic response for corticosteroids. The patient’s symptoms, despite being prescribed typical treatment, gradually deteriorated and the pain became increasingly debilitating. Eventually, the patient underwent total thyroidectomy. As a result, she has become free of symptoms, but the macroscopic picture of thyroid gland, noted during the operation, gave a suspicion of neoplastic process. Nevertheless, histological study of flow samples confirmed the tentative diagnosis of de Quervain’s thyroiditis, despite all previous findings that were not suggestive of it. This report confirms the likelihood that SAT can present atypically. Additionally, it indicates that surgical treatment may be considered in patients with severe, debilitating, persistent thyroid gland pain connected with SAT clinical course. (Pol J Endocrinol 2012; 63 (2): 138–142)
Get Citation

Keywords

subacute thyroiditis; de Quervain’s thyroiditis; thyroid neoplasms; sonoelastography

About this article
Title

What might cause pain in the thyroid gland? Report of a patient with subacute thyroiditis of atypical presentation

Journal

Endokrynologia Polska

Issue

Vol 63, No 2 (2012)

Pages

138-142

Published online

2012-04-27

Bibliographic record

Endokrynologia Polska 2012;63(2):138-142.

Keywords

subacute thyroiditis
de Quervain’s thyroiditis
thyroid neoplasms
sonoelastography

Authors

Ewelina Szczepanek-Parulska
Ariadna Zybek
Maciej Biczysko
Przemysław Majewski
Marek Ruchała

Important: This website uses cookies.tanya dokter More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl