An unusual first presentation of hypopharyngeal carcinoma as thyroid abscess: Case report of a diagnostic challenge

• Published in: International journal of surgery case reports Vol. 81; p. 105723
• Main Authors: Tan, Heng Yao, Sanudin, Siti Hajar, Lum, Sai Guan, Wong, Eugene Hung Chih
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-04-2021; Elsevier
• Subjects: Abscess; Carcinoma; Case Report; Hypopharyngeal; Thyroid; Carcinoma; Hypopharyngeal; Abscess; Thyroid
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2021.105723

•Hypopharyngeal carcinoma is uncommon and is known to involve thyroid gland.•Thyroid abscess as the initial presentation of hypopharyngeal carcinoma is rare.•Clinicians should have raised index of suspicion of this possible diagnosis to avoid delays in management.
Hypopharyngeal carcinoma can involve thyroid gland due to their close proximity. However, an initial presentation as a thyroid abscess is rare in this malignancy. To our knowledge, this is the second reported case in the English literature.
We described a 45-year-old female who presented with dysphagia, hoarseness and anterior neck swelling. The initial CT scan revealed a right thyroid abscess which was incised and drained with no malignancy found in the biopsy of the thyroid tissue. Patient presented one month later with worsening dysphagia, weight loss and a fungating anterior neck mass. Further investigation revealed a locally advanced hypopharyngeal squamous cell carcinoma extending to the right thyroid, upper oesophagus, prevertebral muscles and bilateral cervical lymph nodes (T4bN2cM0). Unfortunately, the patient passed away prior to initiation of treatment.
Clinicians should have raised index of suspicion of a possible underlying hypopharyngeal carcinoma in patients presenting with thyroid abscess and proceed to further investigations in order to ensure early diagnosis and treatment of the malignancy.