Metastatic thyroid carcinoma

Case contributed by Dr Mohammad A. ElBeialy

Presentation

Neck swelling, chest pain, dyspnea and abdominal swelling.

Patient Data

Age: 70 years
Gender: Female
  • The thyroid gland is markedly enlarged with lobulated outline and heterogeneous parenchyma shows multiple hypodense areas as well as course and chunky calcified foci. Retro-sternal extension is noted, more evident on the left side.
  • Bilateral small deep cervical lymph nodes.
  • Marked loculated right pleural effusion is seen with relaxation collapse of the right upper and lower lung lobes.
  • Moderate left pleural effusion is seen with some relaxation collapse of the left lung lower lobe is seen.
  • Cardiomegaly with enlarged all cardiac chambers as well as athermatous calcifications of the coronary arteries. Enlarged supra-hepatic, hepatic and infra-hepatic portions of the IVC as well as hepatic veins with mild ascites.

Case Discussion

Thyroid carcinoma (sub type unknown) with bilateral cervical lymphadenopathy and loculated right malignant  pleural effusion. There is also cardiomegaly with bilateral pleural effusions, congested IVC and hepatic veins as well as mild ascites.

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