Amyloid Goiter: A Peruvian Case Series.

Abstract

Introduction: Amyloid goiter (AG) is a rare cause of thyroid swelling, characterized by deposits of amyloid protein in the thyroid tissue. It can be associated with primary or secondary amyloidosis. Its prevalence in multinodular goiter cases is 0.17%, with rare clinical detection before surgery. Case series: This Peruvian case series comprised three female patients and one male patient, with ages ranging from 28 to 65 years. All individuals had pre-existing inflammatory diseases and reported symptoms including dyspnoea, dysphagia and dysphonia. Upon physical examination, all patients exhibited a grade III goiter. Fine-needle aspiration reported colloid goiter. Three out of the four patients underwent total thyroidectomy and histochemistry revealed AG with positive Congo red staining. Discussion: AG is an uncommon clinical entity. It has been reported to occur more frequently in males, with an average age of diagnosis of 40 years. In our series, we observed a broad age range of patients receiving diagnoses, spanning from 28 to 65 years, with a predominance in females. The consideration of AG should be extended to every patient with an underlying chronic systemic inflammatory disease, especially end stage renal disease. In this context, AG should be included in the differential diagnosis for patients with multinodular goiter exhibiting progressive growth and causing compressive symptoms at the cervical level without affecting thyroid function, as demonstrated in our series. Conclusion: AG, a rare condition, warrants suspicion in the presence of a giant goiter with an underlying systemic inflammatory disease.