case_images: PMC4749199_01
case_images: In colonoscopy sigmoidal mass lesion can be seen
case_images: ijp-11-071-g001.jpg
case_images: PMC4749199_01_ijp-11-071-g001.jpg
case_images: F1
case_images: CEA proportion on that time (Fig. 1). He did not hold clinical signs of hyperthyroidism other than thyroid enlargement. CT scan and ultrasonography showed multinodular goiter with compression effect on trachea.
case_images: In coronal CT scan section shows that enlargement bilateral thyroid mass that encased laryngo-tracheal lumen
case_images: ijp-11-071-g002.jpg
case_images: PMC4749199_01_ijp-11-071-g002.jpg
case_images: F2
case_images: He referred for total bilateral thyroid thyroidectomy that was done (Fig. 2).
case_images: In CT scan of the lung, multiple nodular lesions can be seen
case_images: ijp-11-071-g003.jpg
case_images: PMC4749199_01_ijp-11-071-g003.jpg
case_images: F3
case_images: In chest CT scan that a few multiple small bilateral nodules in both side of lung were seen (Fig. 3). 
case_images: In direct laryngoscopy narrowing of airway in trachea can be seen
case_images: ijp-11-071-g004.jpg
case_images: PMC4749199_01_ijp-11-071-g004.jpg
case_images: F4
case_images: After total successful bilateral thyroidectomy (Fig. 4 and Fig. 5) and immunohistochemical (IHC) (CK7 was positive (Fig. 6) but cytokeratin (CK) 20, CDX-II, thyroid transcription factor-1 (TFF-1) were negative).
case_images: CK7 staining showing a positive reaction
case_images: ijp-11-071-g006.jpg
case_images: PMC4749199_01_ijp-11-071-g006.jpg
case_images: F6
case_images: After total successful bilateral thyroidectomy (Fig. 4 and Fig. 5) and immunohistochemical (IHC) (CK7 was positive (Fig. 6) but cytokeratin (CK) 20, CDX-II, thyroid transcription factor-1 (TFF-1) were negative).