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Massive hemoptysis: an unusual presentation of papillary thyroid carcinoma due to tracheal invasion
  1. Waqas Aslam,
  2. Andrew Shakespeare,
  3. Shirley Jones and
  4. Shekhar Ghamande
  1. Division of Pulmonary, Critical Care & Sleep Medicine, Baylor Scott and White Central Texas, Temple, Texas, USA
  1. Correspondence to Dr Waqas Aslam, drwaqasaslam{at}


A 67-year-man presented to the emergency department with massive hemoptysis, coughing up about 250 mL frank blood in 2–3 hours. Physical examination was significant for tachycardia, tachypnea and blood around the mouth. A CT of the chest did not reveal any aetiology of hemoptysis. Flexible fiberoptic bronchoscopy was remarkable for an actively oozing 1×1 cm sessile subglottic polyp on the anterior tracheal wall. CT neck revealed a 2.5×2.4 cm pretracheal soft tissue mass, bulging into the subglottic trachea. Fine needle aspiration confirmed papillary thyroid carcinoma with BRAF mutation. The patient underwent radical resection and surgical pathology confirmed a 2.5 cm papillary thyroid carcinoma with extensive extra-thyroid extension into the tracheal mucosa. Invasion of the trachea and surrounding structures like larynx and oesophagus is not usual for papillary thyroid carcinoma and may be associated with aggressive cancer behaviour and relatively poor outcome and prognosis.

  • thyroid disease
  • cancer
  • carcinogenesis
  • surgery
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  • Contributors WA and AS were involved in direct patient care with full access to the patient data and drafted the initial manuscript. SJ and SG reviewed the manuscript, provided feedback and helped in the final editing of the manuscript. WA followed up with the patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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