Riedel's struma

Riedel's struma, also known as Riedel's thyroiditis, is a rare, chronic inflammatory disease of the thyroid gland characterized by a dense fibrosis that replaces normal thyroid tissue. This condition leads to a hard, fixed mass in the neck, which can be mistaken for a malignancy. However, Riedel's struma is a benign condition. The etiology of Riedel's thyroiditis remains unclear, but it is thought to be part of the spectrum of IgG4-related systemic diseases. This condition is often associated with other fibrosclerotic disorders, suggesting a possible systemic process.

Symptoms and Diagnosis

Patients with Riedel's struma may present with symptoms related to compression of the trachea, esophagus, or recurrent laryngeal nerves, including difficulty breathing, swallowing difficulties, and hoarseness. The diagnosis is typically made based on clinical examination, imaging studies such as ultrasound or CT scan, and confirmed by histopathological examination showing extensive fibrosis and inflammatory infiltrate within the thyroid.

Treatment

The treatment of Riedel's thyroiditis focuses on managing symptoms and may include thyroid hormone replacement therapy, glucocorticoids, and, in severe cases, surgical intervention to relieve compressive symptoms. However, surgery is challenging due to the fibrotic nature of the gland and its adherence to surrounding structures.

Epidemiology

Riedel's struma is a very rare condition, with a higher prevalence in women than in men. The exact incidence and prevalence of the disease are unknown.

Prognosis

The prognosis for individuals with Riedel's thyroiditis varies. While the condition is benign and slow-growing, the fibrosis can lead to significant complications due to compression of nearby structures. Long-term management may be necessary to monitor and treat these complications.