Pathology diagnosis of an atypical thyroid cartilage lesion

In forensic practice, laryngeal lesions are of particular interest for the pathologist, as they may sign foul play. We report the case of a decedent, whose body was found in an advanced state of putrefaction, at the bottom of a ledge, after a one-month disappearance. The face and neck were skeletised. The autopsy found multiple traumatic injuries. The hyoid bone was separated from the other laryngeal structures and seemed to be macroscopically normal. However, the thyroid cartilage had a thin notch at the base of the right upper horn. The nature of this notch was determined by microscopic examination: analysis showed incompletely ossified fibrous tissue, bordered by a line of enchondral ossification. We concluded that the notch was an old fracture, not concomitant with the polytrauma secondary to the fall that was the cause of death. This case shows that microscopic examination may allow the distinction between recent and old wound. Such a distinction is especially important in this context of polytrauma, where lesions could have been secondary to a fall, caused by a third party or unconnected with events.