Painful thyroid nodule, a misleading presentation of subacute thyroiditis

Abstract

Typical presentation of subacute thyroiditis (SAT) is an anterior neck pain radiating up to the jaw and ear, often associated with asthenia and fever. Biology shows hyperthyroidism and inflammation. The thyroid uptake is low at scintigraphy. However, the clinical presentation of SAT may be misleading. We report two cases of SAT whose initial manifestation was a painful thyroid nodule suspected of malignancy. In both cases, ultrasound feature was a heterogeneous, hypoechoic, ill-defined area with a low vascularization on colour Doppler. These areas were interpreted by radiologist as nodules. Surgery was then considered. Such a presentation should be known by clinicians to prevent unnecessary surgery.

Keywords:

• de Quervain thyroiditis
• subacute thyroiditis
• thyroid nodule
• thyroid ultrasound

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.