Anaplastic Thyroid Cancer

These images show a large heterogeneously enhancing mass which appears to originate from the right thyroid lobe with areas of central hypodensity likely reflecting necrosis. The mass extends from the level of the hyoid to the upper mediastinum, invades the right neck anterior strap musculature, results in significant leftward deviation of the trachea, and markedly compresses the right internal jugular vein. There is no cervical lymphadenopathy or evidence of osseous or cartilage invasion. The differential diagnosis includes anaplastic thyroid cancer, thyroid medullary carcinoma, and multinodular goiter. The presence of muscular invasion and necrosis in an older male makes anaplastic thyroid cancer the most likely diagnosis. This was confirmed on pathology. Anaplastic thyroid cancer is very aggressive tumor with a poor prognosis and mean survival of six months. Treatment is usually palliative, but if caught early, aggressive treatment may be pursued with surgery and/or chemoradiotherapy.