RT Journal Article
SR Electronic
T1 Massive hemoptysis: an unusual presentation of papillary thyroid carcinoma due to tracheal invasion
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e229330
DO 10.1136/bcr-2019-229330
VO 12
IS 8
A1 Waqas Aslam
A1 Andrew Shakespeare
A1 Shirley Jones
A1 Shekhar Ghamande
YR 2019
UL http://casereports.bmj.com/content/12/8/e229330.abstract
AB 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.