Journal of Postgraduate Medicine
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Year : 1989  |  Volume : 35  |  Issue : 4  |  Page : 230-1  

Hydatid disease of the thyroid gland--(a case report).

Arunabha, AK Sharma, AK Sarda 
 

Correspondence Address:
Arunabha


Abstract

Hydatid disease of the thyroid gland, presenting as a solitary thyroid nodule, is being reported below. Pre-operative investigations, including thyroid isotope scanning and aspiration of the nodule, did not help in establishing the diagnosis which was later confirmed by histological examination. Post-operative investigations revealed it to be an isolated involvement of the thyroid gland.



How to cite this article:
Arunabha, Sharma A K, Sarda A K. Hydatid disease of the thyroid gland--(a case report). J Postgrad Med 1989;35:230-1


How to cite this URL:
Arunabha, Sharma A K, Sarda A K. Hydatid disease of the thyroid gland--(a case report). J Postgrad Med [serial online] 1989 [cited 2020 Oct 31 ];35:230-1
Available from: https://www.jpgmonline.com/text.asp?1989/35/4/230/5675


Full Text



 INTRODUCTION



Involvement of the thyroid gland by hydatid disease is a rare phenomenon. Eves amongst patients suffering from the hydatid disease of the liver and lungs, echinococcosis of the thyroid gland occurs in 1-2%.[3]

Between 1970-1986, 573 solitary thyroid nodules (STN) have been operated in one surgical unit of the All India Institute of Medical Sciences, New Delhi and in only one patient, the STN was due a hydatid cyst.

 CASE REPORT



A 24 year old male presented to the surgical outpatient department, with a progressively in. creasing swelling, in front of the lower part of the neck, over a period of five years. There was no history of dysphagia, dysphonia, or features suggestive of thyroid overactivity. Examination revealed a normotensive patient, with no features of hyperthyroidism. The local examination showed a left solitary thyroid nodule, measuring 2.5 x 2.0 cm, firm in consistency, non-tender, not fixed to the surrounding structures, with no cervical lymphadenopathy. The nodule was `cold' on thyroid scanning- Serum T3 was 100 ng/dl (Normal range: 80-120 ng/dl) and serum T4 was 9.8 g/dl (Normal range: 8-12 g/dl). Aspiration of the nodule with a 22G needle revealed 3 ml of clear fluid; but after the aspiration, a residual swelling could be felt. The patient underwent a left hemithyroidectomy. The cut section of the specimen revealed it to be a hydatid cyst and the diagnosis was confirmed on histopathological examination. A complement fixation test done in the immediate post-operative period was positive, but became negative six months after the operation . Post-operative radiological examination of the chest and ultrasound examination of the abdomen were normal.

 DISCUSSION



Hydatid disease of the thyroid is usually a histological surprise. The cyst, as a rule is unilocular and on aspiration, the fluid is invariably clear, although occasional booklets may be seen. The involvement of the thyroid gland occurs with parasites which have escaped into the systemic circulation, somehow bypassing the liver and the lungs.[3]

Hydatid cyst of the thyroid usually presents as a solitary thyroid nodule, which may be adherent to the surrounding structures.[2] Investigations are of little help except that the nodule is always "cold" on isotope scansing,[5] as seen in our case. Needle aspiration of the cyst is an accepted procedure for diagnosis but it may give erroneous results because of haemorrhage in the cyst.[2] In the present study however, it did not establish the diagnosis which was later ascertained by histological examination alone of the resected specimen.

Since the ideal form of treatment in such conditions is resection of the cyst alongwith its pericyst and the surrounding normal thyroid tissue,[3],[4],[6] hemithyroidectomy carried out by us served the purpose. In difficult cases enucleation may be tried but it may be associated with local relapse due to the presence of daughter cysts in the adjoining thyroid tissue.[4]

References

1Apt, W., Barrera, R. and Eggars, M.: Quiste hydatidico del tiroides. (English abstract). Rev. med. Chil., 104: 161-163, 1976.
2Chandra, T. and Prakash, A.: A case of hydatid cyst of thyroid. Brit. J. Surg., 52: 235-237, 1965.
3Dettori, G., Madeddu, G., Marongiu, G. and Biglioli, P.: Echinococcosis of the thyroid gland; two new cases. Amer. Surgeon, 46: 530-533, 1980.
4Misgar, M. S., Ahmed, M. A., Narboo, T. and Rashid, P. A.: Primary echinococcus cyst of the thyroid gland. Internet. Surg., 62: 600, 1977.
5Al-Qassab, K., Abdul-Rahman, H. and Safar, H.: Hydatid disease of the thyroid. Internet. Surg.; 67 (4 suppl.): 435-436, 1982.
6Skalkias, G. D. and Sechas, M. N.: fichinoccocosis of the thyroid gland, report of two cases. J. Amer. Med. Assoc., 200. 178-179, 1967.

 
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