CASE REPORT - Rheumatoid nodule of the thyrohyoid membrane

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J Med Case Reports. 2007; 1: 123.

Published online 2007 October 31. doi: 10.1186/1752-1947-1-123

Rheumatoid nodule of the thyrohyoid membrane: a case report

Background

Rheumatoid nodules are common extra-articular findings occurring in

20% of rheumatoid arthritis patients. They develop most commonly

subcutaneously in pressure areas (elbows and finger joints) and may

occasionally affect internal organs including pleura, lungs, meninges,

larynx, and in other connective tissues elsewhere in the body

Case presentation

We present the case of a 62-year-old male who presented with a midline

neck mass. Clinically it moved on swallowing and tongue

protrusion-suggesting attachment to the thyrohyoid membrane.

Ultrasound examination revealed a cystic lesion in the absence of

cervical lymphadenopathy in a non-smoker. The neck was explored and

histological examination of the excised lesion which was attached to

the thyrohyoid membrane revealed a rheumatoid nodule.

Conclusion

A rheumatoid nodule of the thyrohyoid membrane is very rare. The

triple diagnostic scheme of clinical examination supplemented with

ultrasound and guided fine needle aspiration for neck lumps remains

valid in most cases. If excision is indicated we feel it should be

performed in such a manner that the scar tract could easily be

encompassed in a neck dissection excision should definitive

histological examination be adverse. We suggest that when dealing with

patients with established rheumatoid arthritis one should consider a

rheumatoid nodule as a differential diagnosis for any swelling on the

patient whether it be subcutaneous or deep.

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Read the full article here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174496/

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