Multifocal Fibrosis Involving the Thyroid, Face, and Orbits

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