Endocrine Abstracts

Introduction: Subacute (de Quervainś) thyroiditis is an uncommon altough not a rare condition. Pain in the thyroid and ill-defined hypoechogenic thyroid lesions in ultrasonography are typicall findings, occasionaly are increased thyroid hormones levels. Often preceded by upper respiratory tract infection. The disease is self-limited and often resolves spontaneously, usually without subsequent thyroid function abnormalities, or it may improve with anti-inflammatory drugs and corticosteroids. Fine needly biopsy can confirm the diagnosis in case of doubt, but is not performed frequently.

Case report: A 32-year-old woman complained of pain in a very small area on the anterior side of her neck. Sonographical examination revealed small hypoechogenic lesion 9×7×8 mm[0.3 ml] in an otherwise almost normal thyroid gland corresponding with the pain point. Within one month the pain worsened and the area sonographically enlarged to 27×13×12 mm [2.1 ml] with features typical of subacute thyroiditis. After rapid relief following treatment with prednisone the same problems appeared in the opposite lobe when prednisone therapy was interrupted. In this case the whole lobe was affected. Prednisone therapy again brought immediate improvement. Currently the patient has no problems and sonographical findings are completely normal.

Conclusion: This case report demonstartes an unusually small painful enough lesion caused by subacute thyroiditis.The diagnosis was clear only in the course of further development of the disease.