Thyroid involvement in Rosai-Dorfman disease

Area of Science:

• Endocrinology
• Oncology
• Pathology

Background:

• Rosai-Dorfman disease (RDD) is a rare benign proliferative disorder.
• Thyroid involvement in RDD is exceptionally uncommon, with only a few cases documented.
• Understanding RDD's clinicopathological features in the thyroid is vital for accurate diagnosis and management.

Observation:

• This report details the sixth case of RDD with thyroid involvement, reviewing five prior cases.
• The condition predominantly affects postmenopausal females (mean age 56.3 years), contrasting with nodal RDD in younger males.
• A frequent association with autoimmune thyroiditis suggests a potential shared pathogenesis.

Findings:

• Preoperative diagnosis is challenging, with RDD often mistaken for thyroid malignancy and lymph node metastasis.
• Clinical presentation offers more diagnostic clues than thyroid function tests, sonography, isotope scans, or fine-needle aspiration.
• All six RDD thyroid cases underwent successful surgical treatment, achieving complete remission.

Implications:

• Misdiagnosis of RDD can lead to unnecessary radical surgery and complications like hypothyroidism.
• Distinguishing RDD from thyroid cancer preoperatively is critical to prevent overtreatment.
• Further research into the pathogenesis of RDD and its association with autoimmune thyroiditis is warranted.