An unexpected clinical presentation of primary squamous cell carcinoma of the thyroid gland

Primary squamous cell carcinoma of the thyroid gland (PSCCT) is a rare disease which accounts less than 1% of all thyroid cancers. Patients usually present with enlarging neck mass. In this paper we presented a 76-year-old female patient with PSCCT whose initial finding was a cervical abscess. To our knowledge this is the first PSCCT case in the literature presenting as cervical abscess. The patient was referred to our clinic with dysphasia, shortness in breathing and hyperemic right neck mass, growing in size for 1 week. On physical examination a fluctuant and hyperemic mass was observed at the right cervical region. Magnetic resonance imaging of neck and upper thorax revealed a mass in the area of right thyroid gland, including cystic and necrotic component, progressing to the retrosternal area, surrounding right jugular vein and common carotid artery. An open biopsy was performed. The histopathological diagnosis was squamous cell carcinoma. Because of the extended invasion and infiltration of adjacent tissues, the patient was accepted as inoperable in oncologic council. PSCCT is a rare and aggressive neoplasm of the thyroid gland with poor prognosis. In a patient with deep neck spaces abscess, an underlying PSCCT should be kept in mind to avoid delays in the diagnosis and treatment.