Riedel Thyroiditis

An extremely rare chronic inflammatory disease in which the thyroid is replaced by fibrous tissue.

Written by: Saygı Hospital Health Guide Editorial Board

Last updated: June 9, 2026

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Riedel Thyroiditis?

Riedel thyroiditis is an extremely rare chronic inflammatory disorder characterized by progressive replacement of the thyroid gland with fibrous tissue. The thyroid becomes a stone-hard mass adherent to adjacent neck structures (trachea, esophagus, carotid sheath, recurrent laryngeal nerve).

It is considered within the IgG4-related disease spectrum; serum IgG4 may be elevated. It can coexist with retroperitoneal fibrosis, primary sclerosing cholangitis, and orbital pseudotumor outside of the thyroid.

Diagnosis largely relies on histology from excisional biopsy. Stony hardness and adherence may mimic thyroid cancer; therefore malignancy must be definitively ruled out.

Symptoms

Hard, painless, fixed mass in the neck

Hoarseness (recurrent laryngeal nerve involvement)

Difficulty swallowing

Shortness of breath (tracheal compression)

Hypothyroid symptoms (if fibrosis destroys thyroid tissue)

Hypoparathyroidism (if parathyroid glands are involved)

Risk Factors

Other fibrosis syndromes (retroperitoneal fibrosis)

History of IgG4-related disease

Female sex and age 30-60

Definitive risk factors are unclear; the disease is very rare

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

When a stone-hard, fixed neck mass develops
When hoarseness and shortness of breath accompany a neck mass
When a thyroid mass requires malignancy evaluation

Treatment Methods

Corticosteroids (prednisolone): may slow fibrosis progression early

Tamoxifen: alternative in steroid-refractory or high-dose-requiring cases

Rituximab (B-cell depletion) in IgG4-related disease: in refractory cases

Surgery (isthmus resection): palliative for tracheal compression and dyspnea

Levothyroxine replacement if hypothyroidism develops

Treatment of hypoparathyroidism: active vitamin D and calcium

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.