Journal des troubles thyroïdiens et de la thérapie
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Thyroid Abscess due to Squamous Cell Carcinoma of the Thyroid: A Case Report and Review of Literature

Marwa M Al-Qudhaiby, Mohammad F Hafez, Sundus A Al-Duaij, Abdul Aziz A Ramadan, Thamer M Al-Essa, Sheikha I Abal Khail and Kamal AS Al-Shoumer

A 33 year old female domestic helper presented with painful thyroid swelling of several months duration which was associated with fever and recent dysphagia of about one week duration. A thyroid abscess was diagnosed by ultrasound that was subsequently drained with full coverage by appropriate antibiotics. During her laboratory work up, an elevated corrected calcium level was detected that required to be lowered transiently by a bisphosphonate (pamidronate) infusion. Fine Needle Aspiration Cytology (FNAC) of the thyroid gland and cervical lymph nodes revealed the presence of squamous cell carcinoma in the thyroid with involvement of the cervical lymph nodes. A soft and friable laryngeal growth was noted by an upper gastrointestinal endoscopy performed for assessment of her anemia. The patient condition deteriorated progressively and she died prior to completion of the full work up. The retrospective analysis of her radiological investigations wasn’t confirmatory for the presence of a primary lesion in the larynx. In conclusion, abscess in the thyroid due to primary squamous cell carcinoma is a rare and aggressive entity with poor prognosis. FNAC is effective confirmatory tool, but efforts should be made to rule out metastasis from other sites.