Riedel’s thyroiditis: treatment with tamoxifen

BACKGROUND: Riedel’s thyroiditis is an often disabling disease with

clinical and histologic similarity to several other fibrous

inflammatory disorders. Surgical treatment alone is often

unsatisfactory in permanently alleviating airway compression,

dysphagia, neck immobility, pain, or chronic fatigue syndrome.

Investigation of drugs shown to be of benefit in the

treatment of related fibrous disorders in which hormonal

factors or inflammatory deregulation appear to be important

is indicated. Tamoxifen has not been previously used in the

treatment of Riedel’s thyroiditis.

METHODS: Four patients

with clinical and histologic diagnoses of Riedel’s

thyroiditis were evaluated before and after treatment with

tamoxifen. Each had progressive symptomatic disease of 3 to

16 years’ duration despite one or more surgical procedures

and steroid therapy. Subjective improvement was noted in all

cases, and objective changes were confirmed by periodic

physical and computed tomographic examinations.


Patients have been monitored for 1 to 4 years with subjective

improvement in 100% and objective disease regression ranging

from 50% to 100% in all patients. One patient had complete

regression within 6 months, and another had more than 50%

regression within 3 months. All have returned to predisease

activity levels. There were no significant side effects of

the therapy.

CONCLUSIONS: Tamoxifen has proved to be the most

effective drug therapy available for managing Riedel’s

thyroiditis. Our studies suggest that this is unrelated to

antiestrogen activity. Tamoxifen’s effectiveness may be caused

by a mechanism by which it stimulates the release of

transforming growth factor-beta, which may inhibit the

fibroblastic proliferation characteristic of Riedel’s


Few J, Thompson NW, Angelos P, Simeone D, Giordano T, Reeve T

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