Endocrine Abstracts

Introduction: Thyroid tuberculosis is a rare entity even in countries like Algeria where tuberculosis is endemic.

Observation: We report the case of a 40-year-old woman, with a history of hypertension and severe renal failure, consulting for recent cervical swelling evolving in a context of asthenia, nocturnal fever and weight loss. The clinical examination found a compressive goitre. The biological assessment objectified a primary hypothyroidism and an inflammatory syndrome. Cervical ultrasound revealed a poorly circumscribed strongly hypoechoic area in the left thyroid lobe associated with multiple left cervical adenopathies. The diagnosis of thyroid lymphoma was evoked, the patient benefited from several inconclusive fine needle punctures. Biopsies of the thyroid gland and adenopathies were performed; the histological examination objectified epithelioid granulomas with caseous necrosis.

Discussion: Tuberculosis of the thyroid gland accounts for 0.1-0.4% of all localizations. It mainly affects young adults with a preponderance of the female sex. The clinical picture is not specific. It is most often a basicervical tumefaction of progressive installation accompanied by satellite adenopathies and general signs suggesting cancer in first intention. Thyrotoxicosis or hypothyroidism may exceptionally be observed. The appearance on cervical ultrasound is not specific. Most often, cytopuncture is not contributory. Histological examination confirms the diagnosis. The treatment of thyroid tuberculosis is medico-surgical. Our patient was put on anti-tuberculosis treatment and she was designated for surgical management.