de Quervain's thyroiditis: A review of experience with surgery

Rohit Ranganath, Manish A. Shaha, Bin Xu, Jocelyn Migliacci, Ronald Ghossein, Ashok R. Shaha

Research output: Contribution to journalArticle

Abstract

Background de Quervain's thyroiditis is an inflammatory condition of the thyroid mostly treated medically, rarely requiring surgical treatment. We intend to review the surgical experience with de Quervain's thyroiditis at a tertiary cancer center over a period of 22 years. Methods A retrospective review of medical records from 1992 to 2014 at a tertiary cancer center was performed and all patients with a histopathological diagnosis of de Quervain's thyroiditis were included. Results Ten patients with a histopathological diagnosis of de Quervain's thyroiditis were included in the study. One patient in the study presented with dysphagia due to the goiter. The remaining patients presented with thyroid nodules. None presented with typical symptoms of the disease. Seven of the ten patients that had been evaluated for a goiter at an outside facility underwent fine needle aspiration cytology. Of the seven patients, one patient was suspected to have medullary carcinoma of the thyroid, two had follicular neoplasia, and the others had indeterminate nodules. Eight of the ten patients underwent surgery for suspected malignancy, with eight receiving a total thyroidectomy and two patients getting a thyroid lobectomy with isthmusectomy. Two patients had an abnormally hard gland to palpate during surgery with the others not having any suspicious findings. Seven of the ten of the patients had lymph node sampling from level 6 and all were benign on final pathology. The mean duration of post-operative follow-up was 15 months. There was no morbidity associated with surgery in any of these patients with eight of the ten patients requiring thyroid hormone replacement. None of the patients needed further neck surgery for thyroid disease. Conclusion de Quervain's thyroiditis is an inflammatory condition of the thyroid that is rarely treated surgically. However when presentation is atypical and the FNAC is inconclusive or is suspicious for a malignancy, patients receive surgery putting them at a risk for morbidity. Good clinical assessment with combined use of ultrasound with FNAC especially read by an experienced cytopathologist has the potential to reduce unnecessary operative intervention.

Original languageEnglish (US)
Pages (from-to)534-537
Number of pages4
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume37
Issue number6
DOIs
Publication statusPublished - Nov 1 2016
Externally publishedYes

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ASJC Scopus subject areas

  • Otorhinolaryngology

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