Background: The diagnosis of subacute thyroiditis (SAT) is based mainly on the presence of painful thyroid goitre\nand a significant increase in erythrocyte sedimentation rate (ESR). Proceeding according to these diagnostic criteria\nmay lead to an incorrect diagnosis and treatment. Extremely dangerous is the situation when the diagnosis of SAT\nis erroneously made based on criteria other than ultrasound (US) image and fine needle aspiration biopsy (FNAB),\nwhich leads to delayed diagnosis of malignant tumour with poor prognosis.\nCase presentation: Five patients with typical SAT symptoms are presented. In all of them, anaplastic thyroid cancer\nor metastatic thyroid tumours were finally diagnosed as the cause of the initial symptoms resembling SAT. Most of\nthe patients were initially misdiagnosed and the proper diagnosis of malignancy was delayed.\nConclusions: The authors have proposed the new diagnostic criteria for SAT, and strongly suggest that thyroid\ngland US should be included in the main criteria of SAT diagnosis, together with FNAB result excluding the presence\nof malignant tumour.
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