Primary thyroid tuberculosis: a rare etiology of hypothyroidism and anterior cervical mass mimicking carcinoma / Tuberculose tireoidiana primária: rara etiologia de hipotireoidismo e massa cervical anterior mimetizando carcinoma
Arq. bras. endocrinol. metab
; 53(4): 475-478, jun. 2009. ilus
Article
de En
| LILACS
| ID: lil-520774
Bibliothèque responsable:
BR1.1
ABSTRACT
OBJECTIVE:
The involvement of the thyroid by tuberculosis (TB) is rare. Hypothyroidism caused by tissue destruction is an extremely rare report. Our aim was to report a patient with primary thyroid TB emphasizing the importance of diagnosis, despite the rarity of the occurrence. CASE REPORT Women, 62 years old, showing extensive cervical mass since four months, referring lack of appetite, weight loss, dysphagia and dysphonia. Laboratorial investigation revealed primary hypothyroidism. Cervical ultrasound expansive lesion in left thyroid lobe, involving adjacent muscle. Computed tomography scan 13 cm diameter cervical mass with central necrosis. Fine needle biopsy hemorrhagic material. Surgery total thyroidectomy, left radical neck dissection and protective tracheotomy. The pathological examination showed chronic granulomatous inflammatory process with areas of caseous necrosis and lymph node involvement. The thyroid baciloscopy was positive. Pulmonary disease was absent. The patient was treated with antituberculosis drugs.CONCLUSIONS:
Thyroid TB is not frequent, and should be considered as differential diagnosis of hypothyroidism and anterior cervical mass.RESUMO
OBJETIVO:
A tuberculose tiroidiana ocorre raramente. O hipotireoidismo decorrente da destruição tiroidiana é um relato raríssimo. Nosso objetivo foi descrever o caso de paciente com tuberculose tiroidiana primária e ressaltar a raridade e a importância da doença. RELATO DO CASO Mulher, 62 anos, apresentando massa cervical extensa há quatro meses, associada à inapetência, à perda de peso, à disfonia e à disfagia. A investigação laboratorial mostrou hipotireoidismo primário. Ultrassonografia lesão expansiva em lobo esquerdo, envolvendo musculatura subjacente. Tomografia computadorizada massa heterogênea com centro necrótico, 13 cm de diâmetro. Biópsia por agulha fina material serossanguinolento. Cirurgia tireoidectomia, dissecção radical à esquerda e traqueostomia protetora. Exame anatomopatológico processo inflamatório crônico granulomatoso com áreas de necrose caseosa e comprometimento linfonodal. Baciloscopia tiroidiana positiva. Ausência de comprometimento pulmonar. A paciente foi tratada com drogas antituberculosas.CONCLUSÕES:
Tuberculose tireoidiana não é frequente, mas deve ser considerada como diagnóstico diferencial de hipotireoidismo e massa cervical anterior.Mots clés
Texte intégral:
1
Indice:
LILACS
Sujet Principal:
Maladies de la thyroïde
/
Tuberculose endocrinienne
Type d'étude:
Diagnostic_studies
/
Etiology_studies
Limites du sujet:
Female
/
Humans
langue:
En
Texte intégral:
Arq. bras. endocrinol. metab
Thème du journal:
ENDOCRINOLOGIA
/
METABOLISMO
Année:
2009
Type:
Article