Giant Anaplastic Thyroid Carcinoma Arising in a Neglected Goiter: A Case Report

Introduction: Diffusely enlarged giant thyroid glands are becoming increasingly infrequent. However, in some geographical areas they are still relatively common. Anaplastic thyroid carcinoma is rare but is an aggressive and lethal malignancy. Since it is associated with severe complications, surgical treatment of giant goiter requires a high level of expertise. Material and Methods: Herein, a case of giant goiter in a 71-year-old female patient, diagnosed 40 years ago and gradually progressed in size has been presented. Although she was informed about the biopsy and consequent surgery indication years ago, she refused to undergo any surgical intervention. She was suffering of a huge neck swelling with a sense of tightness and heaviness that interferred with her neck movements. Computed tomography imaging studies revealed a giant goiter deviating the trachea to the right and lymphadenopaties appearing as metastatic lesions in lungs and mediastinum respectively. Result: Total thyroidectomy was performed. The surgical specimen weighed 2.5 kg, had a right lobe 8.5 x 5 x 3.5 cm in size and a left lobe 18.5 x 17.5 x 10 cm in size. The pathological examination reported the specimen as anaplastic thyroid carcinoma. Conclusion: Thyroid diseases associated with goiter should be surgically treated without a delay since those cases could be complicated with malignant transformation in the gland and considerably increased surgical complication rates due to advanced age and increased size of goiter.