Abstract
The patient had developed a right thyroid mass the size of a ping-pong ball 41 years before presentation; however, the size of the mass did not change during this period. Thyroid ultrasound examination and puncture cytology had been performed almost every year for 19 years, but the cytology revealed no malignant findings. Eleven years before presentation, a lesion appeared in the upper lobe of the left lung and was followed up as a suspected hamartoma, and nine years before presentation a similar lesion appeared in the middle lobe of the right lung. Seven years before
presentation, cytology of the right thyroid gland was classified as class III and surgery was recommended, but the patient refused. One year before presentation, the thyroid mass had enlarged to 60 × 70 mm, and the patient was hospitalized with dyspnea. Although the symptoms temporarily improved, the patient developed a respiratory tract infection on the 123rd day of hospitalization, experienced pain in the right thyroid mass on day 148, and died of pneumonia on day 195. Consent for an autopsy was obtained, and it was performed on the same day. The tumor size at autopsy was 130 × 90 mm. The patient was diagnosed with follicular and undifferentiated thyroid cancer.
