Introduction

Suppurative thyroiditis comprises less than 1% of thyroid diseases. More often, this condition occurs in immunocompromised individuals or those with pre-existing thyroid disorders. In adults aged 50 years and older, thyroid cancer should also be excluded.

Methods

A 57 year-old male was urgently hospitalized with pain and tenderness of the left side of the neck. Ultrasonography revealed pronounced swelling of the neck soft tissues and a non-homogenous mass 2 cm below the skin surface 9.0 x 5.2 x 9.0 cm in size, which was spreading behind the sternum. Contrast-enhanced CT-angiography of the neck demonstrated a thyroid gland left lobe lesion 7.0 x 6.0 x 9.0 cm in size with a thin capsule, containing a fluid component with strings of calcification and accumulating contrast at the periphery, tracheal compression by 50%, and massive locoregional lymphadenopathy. An abscess of the thyroid gland left lobe cyst was suspected.

Results

Considering the patient's stable condition, ultrasound-guided drainage of the formation under local anesthesia was decided upon and performed. In the post-operative period, the patient's vital signs were within the normal ranges, and he received conservative therapy to the full extent. A pathology report of the lesion stated the presence of a chronic abscess and a thyroid gland left lobe tumor of undetermined malignancy potential. The patient underwent left hemithyroidectomy in a planned manner. The specimen histological picture met the criteria for papillary thyroid cancer of the infiltrative follicular variant, pT3aN0M0, with signs of lymphovascular invasion. The edges of the resection were without signs of tumor growth.

Conclusions

Thyroid cancer can be induced by inflammatory processes. In this case, a male patient was treated for thyroid abscess, but eventually he was diagnosed with papillary thyroid cancer. Since the risk of having cancer increases with age, older patients should be monitored more closely for the presence of malignancy.