Sonographic changes in the thyroid gland after sclerotherapy with doxycycline can be mistaken for thyroid cancer

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Abstract

BACKGROUND: The literature considers sclerotherapy to be a safe and effective treatment for benign thyroid cysts. No subsequent diagnostic problems have been reported as a complication. We report the occurrence of focal inflammation after said therapy, mimicking a thyroid malignancy.

CASE PRESENTATION: We report a case of a young male with a solitary strongly suspicious lesion in the thyroid. The patient had undergone prior sclerotherapy of a thyroid cyst with Doxycycline. The lesion appeared to be a focal area of inflammation and thus iatrogenic in nature. Systemic use of doxycycline is known to sometimes cause a non-immune chemical thyroiditis, dubbed as black thyroid due to the intense black discoloration of the thyroid. It might be that the instillation of doxycycline was responsible for a similar, more localized area of thyroiditis.

CONCLUSIONS: For the work-up of a solitary suspicious thyroid lesion, the medical history of the patient should always be considered. In case of prior ipsilateral sclerotherapy, a reactive inflammatory response may mimic thyroid malignancy. A fine needle aspiration should be performed to exclude thyroid cancer. Treatment is not necessary; the process appears to be self-limiting as evidenced in the follow-up of this case.

Original languageEnglish
Article number33
Pages (from-to)33
JournalThyroid research
Volume16
Issue number1
DOIs
Publication statusPublished - 17 Aug 2023

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