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Summary Riedel's thyroiditis is a rare type of chronic thyroiditis, associated with fibroinflammatory process and invasion into surrounding tissues, leading to compressive symptoms. A 45-year-old man had a left thyroid mass, presenting with hypotension and bradycardia many times. He was diagnosed with vasovagal reflex caused by cervical vessel compression due to a thyroid lesion. We performed the emergency operation, and most of the left thyroid was removed to relieve the compression on cervical vessels. The result of pathology proved to be Riedel's thyroiditis. The vasovagal reflex did not occur any more during the 28-month follow up, except on the 3 rd day after the surgery. Six months after the thyroidectomy, the patient was found to have retroperitoneal fibrosis, diagnosed by biopsy during a laparotomy for biliary disease. Riedel's thyroiditis can lead to a vasovagal episode and might not be a primary thyroid disease but rather a manifestation of the systemic disorder, multifocal fibrosclerosis. [ABSTRACT FROM AUTHOR]

Riedel''s thyroiditis, known as invasive fibrous thyroiditis, is a very rare form of chronic thyroiditis. It is hard to make the diagnosis without surgical biopsy. We present a case of Riedel''s thyroiditis in a 52-year-old female with past history of Hashimoto''s thyroiditis. She suffered from bilateral neck pain, which radiated to both lower jaws. The erythrocyte sedimentation rate was 125 mm/hour. Subacute thyroiditis superimposed on Hashimoto''s thyroiditis was diagnosed and treated with steroid. However the response was poor and she had a history of severe peptic ulcer. To avoid inducing the peptic ulcer by steroid, she received bilateral subtotal thyroidectomy. During surgery, the thyroid had severe adhesion to surrounding soft tissue and the pathology showed Riedel''s thyroiditis. The neck pain improved after thyroidectomy. Tamoxifen has been given for 8 months and the size of remnant thyroid decreased to 8 mm. We concluded that combined thyroidectomy and tamoxifen successfully cured a patient with Riedel''s thyroiditis. [Copyright &y& Elsevier]

Abstract: Riedel''s thyroiditis is a rare variant of thyroiditis and characterized by the replacement of thyroid parenchyma by extensive fibrosis. Typically, the thyroid is diffusely involved and a painless, hard anterior neck mass shows clinical features similar to those of anaplastic thyroid carcinoma: a rapidly enlarging, hard, fixed thyroid mass and symptoms such as dysphagia, dysphonia, and dyspnea. We experienced a case of Riedel''s thyroiditis that had presented rapidly growing, hard, fixed, thyroid mass mimicking anaplastic thyroid cancer in a 41-year-old female patient with longstanding benign thyroid nodule for 6 years. The clinical features were indistinguishable from that of anaplastic transformation and open biopsy could exclude anaplastic thyroid cancer. After surgery final diagnosis of Riedel''s thyroiditis could be made by typical microscopic findings and immunohistochemical studies. We reported the case with review of the related literatures. [Copyright &y& Elsevier]