PRIMARY THYROID-CARCINOMA AND THYROTOXICOSIS

A 60-year-old man noticed rapid enlargement of a long-standing thyroid goitre, with dysphagia and difficulty in breathing. Thyrotoxicosis wa s diagnosed. Chest X-ray revealed multiple pulmonary metastases. He un derwent near-total thyroidectomy. The histopathology revealed an undif ferentiated thyroid carcinoma with some areas of papillary carcinoma a nd its follicular variant. Postoperative I-131 total body scan showed residual thyroid tissue in the neck and one functioning metastasis in the right rib, posteriorly. The patient's condition deteriorated rapid ly and he died from pneumonia. The autopsy showed widespread metastase s of undifferentiated thyroid carcinoma. Only the right rib contained the follicular variant of papillary carcinoma.