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[Thoracic pain, shock-inducing gastrointestinal bleeding]

S Bauer1, H P Wirth, R Flury

  • 1Departement für Innere Medizin, Universitätsspital Zürich.

Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|February 1, 1994
PubMed
Summary

Anaplastic thyroid carcinoma presenting as an esophageal lesion caused thoracic pain and bleeding. Palliative radiotherapy effectively treated the tumor and improved the patient's condition.

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Area of Science:

  • Oncology
  • Gastroenterology
  • Radiology

Background:

  • A 65-year-old patient presented with thoracic pain, suspected myocardial infarction, and a three-year history of left recurrent nerve paresis.
  • The patient developed shock with anemia, prompting an urgent upper gastrointestinal endoscopy.

Observation:

  • Endoscopy revealed a diverticulum-like lesion in the proximal esophagus as the bleeding source.
  • Contrast X-ray showed a 2 cm cavity in the proximal esophagus.
  • CT imaging identified a large mediastinal mass extending from the thyroid to the diaphragm.

Findings:

  • Ultrasound-guided fine-needle aspiration and endoscopic biopsies diagnosed anaplastic thyroid carcinoma with esophageal erosion.
  • The patient received palliative radiotherapy.

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Implications:

  • Palliative radiotherapy was effective, leading to rapid esophageal defect healing.
  • The patient showed good recovery and remained well nine months post-treatment.
  • This case highlights the importance of considering rare presentations of anaplastic thyroid carcinoma, including esophageal involvement.