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Riedel's thyroiditis,
woody thyroiditis or invasive fibrous
thyroiditis
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- This form of Thyroiditis is
usually found in elderly and middle-aged women. It is quite
rare. In this disease, the patient has a very hard thyroid
gland, as well as symptoms caused by pressure put on other
structures in the neck. Treatment is with a medicine called
Tamoxifen.
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- The thyroid gland is enlarged, hard, and does not move very freely.
- The thyroid gland becomes very hard because of all the fibrous tissue that has invaded it.
- The patient often has symptoms due to pressure on other structures in the neck. These symptoms may include difficulty swallowing and breathing, pain in the neck area, or hoarseness.
- The patient usually has symptoms of
Hypothyroidism.
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- Riedel's Thyroiditis is caused by fibrous tissue invading the thyroid gland. It is not known why this happens.
- However, many people with this
disease have other related diseases, such as retroperitoneal
fibrosis, fibrosing mediastinitis, biliary tract sclerosis,
or sclerosing Cervicitis.
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- The symptoms and examination help make the diagnosis.
- Usually, the T4 and T3 resin uptake (these are tests of the thyroid gland) are often low.
- A Nuclear scan of the thyroid gland usually shows low uptake.
- The TSH (thyroid stimulating hormone) level is usually increased.
- Sometimes a biopsy may be needed to
confirm the diagnosis.
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- Treatment is with Tamoxifen.
Tamoxifen is often used to treat women with Breast Cancer.
However, it also works quite well for people with Riedel's Thyroiditis.
- Tamoxifen leads to either partial or complete remission in most people within 3-6 months.
- Treatment, however, usually needs to be continued for years.
- Also, some people are treated with steroids in order to try to reduce some of the pain and swelling associated with this condition.
- Surgery is done only if absolutely
necessary. Surgery is usually very difficult and often not
very successful.
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