A Rare Case of Hemangioma in the Thyroid: Clinical Presentation and Management Insights

Thyroid hemangiomas are rare. However, preoperative investigations should be considered because of the potential risk of significant intraoperative hemorrhage. Here, we report a case of thyroid hemangioma in a 58-year-old woman. Physical examination revealed a large, hard, non-tender mass measuring approximately 60 mm in the anterior neck. Laboratory tests indicated hypothyroidism (triiodothyronine: 2.32 pg/mL, thyroxine: 0.62 ng/dL, thyroid-stimulating hormone: 22.4 nIU/mL) and markedly elevated anti-thyroglobulin (1,357 IU/mL) and anti-TPO (405 IU/mL) antibodies. Ultrasonography revealed a well-defined, heterogeneous internal mass measuring 60 mm within the right lobe of the thyroid gland, with a hyperechoic image bordering the mass. Contrast-enhanced CT revealed a 44 mm mass in the right lobe with calcification at the rim and gradual contrast enhancement towards the interior. Fine-needle aspiration cytology (FNAC) yielded mostly blood cells, with no evident epithelial components. A right thyroid lobectomy was performed, and post-operative histopathology confirmed a diagnosis of hemangioma. This case highlights the importance of considering thyroid hemangiomas in the differential diagnosis of thyroid masses due to the risk of intraoperative hemorrhage. It also emphasizes the role of various imaging modalities such as ultrasonography and CT in the preoperative evaluation of such cases.