Riedel's thyroiditis
The Riedel struma ( Riedel 's thyroiditis, " hard as iron Struma ", named after Bernhard Moritz Carl Ludwig Riedel ) is a very rare invasive sclerosing thyroiditis ( thyroiditis ), which usually occurs in middle-aged women.
- Invasive means here: in the environment waxing.
- Sclerosing means scaring.
The cause of the disease is unknown. It comes to a complete destruction of thyroid tissue by fibrotic proliferation ( connective tissue remodeling ). Frequently exceeding the thyroid capsule with infiltration of surrounding tissue neck is observed.
Diagnostics
The clinical examination reveals a palpable and " hard as iron " enlarged thyroid goiter. This may lead to local problems with narrowing of the trachea and the cervical vessels, but also to a large displacement of cervical nerves to a recurrent laryngeal nerve palsy. The thyroid gland is no longer displaced during swallowing as a sign of adhesions with the surrounding neck tissue, but not always show a sensitivity to pain.
In the ultrasound examination of the thyroid gland, the volume can be determined and demonstrate nodular changes and infiltration into the neck tissues. Following the ultrasound, a scintigraphy of thyroid follow that allows an assessment of the functional position throughout the thyroid gland and organ of individual sections. Typically, the scintigram in the Riedel struma shows an overall decreased uptake of technetium. For detection of cold nodules always rise to a suspicion of carcinoma, resulting in surgical removal result.
One can also take an appropriate tissue sample from the affected thyroid gland to make the diagnosis.
Differential diagnoses
Must be differentiated especially thyroid cancer and the fibrous variant of Hashimoto 's thyroiditis.
Therapy
Since the Riedel goiter caused exclusively local problems in the neck, it should be as early as possible surgically removed. In the subsequent histological examination of the removed tissue can then also a cancer excluded (or proven) to be.
There are no reliable experience with conservative treatment approaches. After surgical removal of the thyroid gland ( thyroidectomy ) must be taken for life artificial thyroid hormones.