Abstract
An 80-year-old woman presented with acute breathlessness and a 2-month history of a painless, huge neck mass. She reported malaise and weight loss without sweating, fever, palpitation, nervousness, or tremors. She had no history of trauma to the neck. She had dyspnea, wheezing, and cyanosis on examination. A hard, smooth, rubbery mass was observed on her neck (Fig. 1 , anterior view). Laboratory analysis revealed mild normochromic normocytic anemia and the following values: erythrocyte sedimentation rate, 80 mm/h (reference range, 0-20 mm/h); C-reactive protein, 157 mg/L (reference range, 0-10 mg/L); lactate dehydrogenase, 450 U/L (reference range, 100-210 U/L); thyrotropin, 83.2 mIU/L (reference range, 0.3-5.0 mIU/L); free triiodothyronine, 1.21 pg/mL (reference range, 1.8-4.2 pg/mL); free thyroxine, 0.3 ng/dL (reference range, 0.7-1.85 ng/dL); and thyroperoxidase antibodies, 200 IU/mL (reference range, 0-50 IU/mL).
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