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Goiter and Abdominal Mass: A Rare Presentation of Riedel’s Thyroiditis
  1. Thao Nguyen1,
  2. Brian Stewart2,
  3. Jaymin Patel1 and
  4. Bhagwan Dass1
  1. 1Medicine, University of Florida, Gainesville, Florida, USA
  2. 2Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Dr Thao Nguyen; Thao.Nguyen{at}


Riedel’s thyroiditis (RT) is a rare inflammatory autoimmune disease, often associated with various forms of systemic fibrosis such as sclerosing mesenteritis (SM). A woman in her late 30s presented with a diffusely enlarged firm goiter and a mesenteric mass complicated by biliary obstruction and hydronephrosis. Labs and thyroid ultrasound were consistent with autoimmune thyroiditis. Abdominal imaging demonstrated a mesenteric mass that encased mesenteric vessels and ureter. Flow cytometry and infectious workup were negative. Both thyroid and mesenteric biopsies revealed dense fibrosis with patchy lymphoplasmacytic aggregates, no evidence of carcinoma, lymphoma, or IgG4-related disease, which confirmed diagnoses of RT and SM. She improved clinically with steroids. The coincidental timing of thyroid enlargement and the mesenteric mass, and the similarity in histology suggest an association between RT and SM. Overall, the case highlights the challenges in diagnosing RT given its rarity and emphasises the importance of early treatment to prevent systemic involvement.

  • Thyroid disease
  • Thyroiditis
  • Rheumatology

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  • Contributors All authors made individual contributions to authorship. JP: was involved in the diagnosis and management of this patient. BS: pathology images and explanation. TN: was involved in literature review and manuscript submission. BD: oversaw the entire case. All authors reviewed and approved the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.