Riedel's Thyroiditis and Noninvasive Follicular Neoplasm With Papillary-Like Nuclear Features: A unique coexistence...

Area of Science:

• Endocrinology
• Pathology
• Surgical Oncology

Background:

• Riedel's thyroiditis is a rare, fibrosing inflammatory condition of the thyroid gland, often clinically mimicking malignancy.
• The simultaneous occurrence of Riedel's thyroiditis and noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP) is exceptionally rare and previously unreported.
• Thyroid abscesses can present with similar symptoms, complicating the initial diagnosis.

Purpose of the Study:

• To report the first documented case of concurrent Riedel's thyroiditis and NIFTP.
• To discuss the diagnostic challenges and atypical presentation of this rare coexistence.
• To outline the management strategies employed for this unique clinical scenario.

Main Methods:

• Case presentation of a 63-year-old male with acute cervical mass, fever, and dysphagia.
• Diagnostic workup included imaging (CT scan) and histopathological examination of the thyroid gland post-thyroidectomy.
• Postoperative assessment included evaluation for systemic fibrotic involvement and complications.

Main Results:

• Histopathology confirmed Riedel's thyroiditis with extrathyroidal extension and an underlying NIFTP.
• The patient's initial presentation mimicked a thyroid abscess, requiring antibiotic treatment before surgery.
• Postoperative complications included left vocal cord paresis and primary hypoparathyroidism; systemic fibrosis was excluded.

Conclusions:

• The coexistence of Riedel's thyroiditis and NIFTP presents significant diagnostic and management challenges.
• Early recognition and appropriate surgical intervention are crucial for optimal patient outcomes.
• This case underscores the importance of thorough histopathological evaluation in complex thyroid pathologies.