February 1976

Multifocal Fibrosis Involving the Thyroid, Face, and Orbits

Author Affiliations

From the Department of Medicine, Mount Sinai Hospital, New York. Dr Amorosa is now with the College of Medicine and Dentistry, Rutgers Medical School, Piscataway, NJ.

Arch Intern Med. 1976;136(2):221-223. doi:10.1001/archinte.1976.03630020075016

The reports associating fibrous thyroiditis (Riedel struma) with other multifocal fibrosclerosing syndromes have suggested that the former disease may not be solely limited to the thyroid gland. Fibrous thyroiditis has been found with mediastinal fibrosis, sclerosing cholangitis, retroperitoneal fibrosis, localized pulmonary fibrosis, and periorbital and retroorbital fibrosis. A common causative factor has not been determined. Results of steroid therapy have been inconclusive, with random successes. We report a case of a rare association of thyroidal and retroorbital fibrosis in which improvement occurred coincident with steroid and cyclophosphamide therapy.

PATIENT SUMMARY  An enlarged right lobe of the thyroid was found in a 54-year-old woman in 1965. During the next five years, she experienced pain in her neck that became progressively worse, and, in January 1970, she was found to have a diffusely enlarged thyroid. A clinical diagnosis of thyroiditis was made. She was treated with prednisone, 20 mg daily for three

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