Acute Suppurative Thyroiditis in a Primary Intrathoracic Goiter

Objective: To describe a case of acute suppurative thyroiditis and focal abscess formation in a patient with a primary intrathoracic goiter. Methods: We summarize the initial clinical manifestations, the pathologic findings, and the surgical treatment of a woman with an enlarging mediastinal mass. Results: A 41-year-old woman had a fever and a sudden increase in severity of compressive symptoms after a remote urinary tract infection. Smears from an intraoperative fine-needle aspiration biopsy showed necrotic debris, polymorphonuclear leukocytes, hemosiderin-laden macrophages, and degenerated follicular epithelial cells. Urine and tissue cultures grew Escherichia coli. The patient underwent resection of an 800-g primary intrathoracic goiter with associated degeneration, necrosis, hemorrhage, and abscess formation. Conclusion: To our knowledge, this is the first reported case of acute suppurative thyroiditis and abscess formation occurring within a primary intrathoracic goiter.