Primary Thyroid Tuberculosis: An Uncommon Presentation of a Thyroid Mass

• Published in: Ear, nose, & throat journal nose, & throat journal, 2022-03, Vol.101 (3), p.167-169
• Main Authors: Laitman, Benjamin M., Samankan, Shabnam, Hwang, Songhon, Chai, Raymond L.
• Format: Article
• Language: English
• Subjects: Case reports; Cysts; Gangrene; Humans; Mycobacterium tuberculosis; Otolaryngology; Thyroid Diseases - complications; Thyroid gland; Tuberculosis
• ISSN: 0145-5613; 1942-7522
• DOI: 10.1177/0145561320949481

A 70-year-old male with no significant past medical history presented with a large fluctuating right neck mass present for the previous 4 months. The mass initially improved with a 10-day course of Augmentin and Bactrim but began to grow again slowly over the following number of months. The patient reported 7/10 neck pain, difficulty breathing while supine, dysphagia, and voice changes.Contrast enhanced computed tomography (CT) of the neck revealed a 7.6-cm rim-enhancing area of cystic necrosis within a lesion of the right thyroid bed. This demonstrated extracapsular extension involving the infrahyoid strap muscles but not the overlying skin (Figure 1A). An additional hypodense nodule was also noted in the left thyroid lobe. The laryngeal skeleton and trachea remained patent with possible cricoid invasion, although there was mass effect on the trachea. No central or lateral compartment lymph node disease was identified. Positron emission tomography-CT demonstrated a hypermetabolic right thyroid mass with an standardized uptake value (SUV) max of 13.0 (Figure 1B).