70 pound F with 10 year history of severe weight loss with symptoms for vomiting undigested food and dysphagia has Hashimoto’s thyroiditis and a “thyroid nodule” on outside Ultrasound. Neck examination was negative for a thyroid nodule. TFTs were normal except positive TPO antibodies. My endocrine neck Ultrasound found a mass inferior to the left thyroid lobe. It had a clear hyperechoic line separating it from the thyroid gland. A fine needle biopsy of the mass was consistent with a Zenker’s pouch with squamous cells, She was referred to specialists to treat her Zenker’s diverticulum. She was treated with low dose LT4 for her Hashimoto’s thyroiditis. Her problem was considered a stomach issue not the pouch by all her prior physicians.
This is the 5th case of mistaken Zenker pouch for a thyroid nodule. One case came with a note stating the radiologist missed the thyroid nodule and got into the esophagus.
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