case_images: PMC6854985_01
case_images: CT scan (axial) showing a large hypoechoic nodule with ill-defined nodular margins. This is suggestive of a solid-cystic nodule in the left thyroid.
case_images: CRIE2019-8641267.001.jpg
case_images: PMC6854985_01_CRIE2019-8641267.001.jpg
case_images: fig1
case_images: Contrast-enhanced CT scan (Figure 1) showed a 6.4 x 5.6 x 4.9 cm solid-cystic nodule arising from the left thyroid lobe and encasing the left common carotid artery.
case_images: CT scan (coronal) showing gross deviation of the common carotid artery. The lack of fat plane suggests involvement of the carotid. The trachea is deviated but is not narrowed.
case_images: CRIE2019-8641267.002.jpg
case_images: PMC6854985_01_CRIE2019-8641267.002.jpg
case_images: fig2
case_images: The trachea was deviated to the right but there was otherwise no airway narrowing (Figure 2).
case_images: CT scan (axial) showing a 4.3 x 3.4 cm spiculated hyperechoic lesion in the left upper lobe abutting the pleura.
case_images: CRIE2019-8641267.003.jpg
case_images: PMC6854985_01_CRIE2019-8641267.003.jpg
case_images: fig3
case_images: In addition, the CT scan also revealed a 4.3 x 3.4 cm spiculated mass in the left upper lobe of the lung as well as several other smaller subcentimeter lung nodules (Figure 3).
case_images: Lung parenchyma infiltrated by poorly differentiated carcinoma with squamoid features. Prominent background desmoplasia is noted.
case_images: CRIE2019-8641267.004.jpg
case_images: PMC6854985_01_CRIE2019-8641267.004.jpg
case_images: fig4
case_images: This showed atypical squamous cells highly suspected for squamous cell carcinoma (Figure 4).
case_images: Tumour cells are diffusely immunoreactive to P40 stain. This finding is indicative of squamous differentiation. Diffuse P40 staining in tumour cells is in keeping with squamous cell carcinoma.
case_images: CRIE2019-8641267.005.jpg
case_images: PMC6854985_01_CRIE2019-8641267.005.jpg
case_images: fig5
case_images: Immunohistochemistry staining (Figure 5) showed diffuse reactivity to p40, CK7 and paired box 8 (PAX-8) and were negative for Napsin A and thyroid transcription factor-1 (TTF-1).