extremely rare form of chronic inflammation of the thyroid gland, in which the glandular tissues assume a densely fibrous structure, interfering with production of thyroid hormone and compressing the adjacent trachea and esophagus. The thyroid becomes enlarged, often asymmetrically, to form a firm, hard mass of scar tissue that may be confused with cancer of the thyroid. Other organs may also be involved, including the parotid (salivary) glands, the lungs, and the bile ducts of the liver; the fibrosis may also spread beyond the thyroid to surrounding tissues. The cause of the disease, which occurs most commonly in middle-aged and older individuals, is unknown. Treatment (therapeutics) is largely symptomatic and may include thyroid replacement if hypothyroidism (deficiency of thyroid hormone) occurs. Surgery to remove the affected tissue may also be needed to relieve pressure on surrounding organs.