PMC4749199_01
In colonoscopy sigmoidal mass lesion can be seen
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F1
CEA proportion on that time (Fig. 1). He did not hold clinical signs of hyperthyroidism other than thyroid enlargement. CT scan and ultrasonography showed multinodular goiter with compression effect on trachea.
In coronal CT scan section shows that enlargement bilateral thyroid mass that encased laryngo-tracheal lumen
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F2
He referred for total bilateral thyroid thyroidectomy that was done (Fig. 2).
In CT scan of the lung, multiple nodular lesions can be seen
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F3
In chest CT scan that a few multiple small bilateral nodules in both side of lung were seen (Fig. 3). 
In direct laryngoscopy narrowing of airway in trachea can be seen
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F4
After total successful bilateral thyroidectomy (Fig. 4 and Fig. 5) and immunohistochemical (IHC) (CK7 was positive (Fig. 6) but cytokeratin (CK) 20, CDX-II, thyroid transcription factor-1 (TFF-1) were negative).
CK7 staining showing a positive reaction
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F6
After total successful bilateral thyroidectomy (Fig. 4 and Fig. 5) and immunohistochemical (IHC) (CK7 was positive (Fig. 6) but cytokeratin (CK) 20, CDX-II, thyroid transcription factor-1 (TFF-1) were negative).