PMC5899845_01
Significantly enlarged thyroid mass causing tracheal deviation to the right (blue arrow) with hypoattenuation within the left thyroid lobe (red arrow) (a). Scattered calcifications (green arrows) apparent within the lesion (b) with extension into the anterior mediastinum and continued deviation of the trachea (c).
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Subsequent CT scan of her chest showed the mass extending into the anterior mediastinum with scattered calcifications within the mass (Figure 1).
(a) Intraoperative photograph of total thyroid specimen, greatest dimension 8.7 cm in size. (b) Microscopic pathology of squamoid and undifferentiated thyroid cells.
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Intraoperative biopsies sent for frozen section analysis were reported as poorly differentiated carcinoma, suggestive of anaplastic thyroid carcinoma (Figure 2).
Metastatic work-up demonstrates a pulmonary nodule within the right upper lobe (1.1 x 2.1 cm) with central cavitation (blue arrow) (a) and increased 99 mTc HDP uptake within the right intratrochanteric femur positive for a destructive lytic lesion (red arrow) (b).
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Subsequent whole-body CT and nuclear medicine scan found multiple bilateral pulmonary nodules with central cavitation and a destructive right intertrochanteric lytic lesion with pathological fracture (Figure 3).