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, heterogeneous, and normal echogenicity ( 3 , 15 ). Hypoechogenicity was defined as an ultrasound signal significantly lower than normal thyroid tissue. Heterogeneous echogenicity is defined as the interweaving of low signal and normal tissue signal ( 3
Endocrinology Unit, Graves’ Orbitopathy Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Ophthalmology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Department of Specialistic Surgical Sciences, Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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National Institute of Molecular Genetics (INGM) “Romeo and Enrica Invernizzi”, Milan, Italy
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thyroid technetium-99m uptake, and thyroid ultrasound revealed typical features of GD; thus, she was put on methimazole therapy. One year after the onset of GD, she developed progressive moderate-to-severe active TED, and was treated with weekly IVGC