LAUSR

A 36-year-old woman presented with a 4-month history of right neck lump. She had mild shortness of breath, but no dysphagia or voice changes. Clinical examination found a firm right thyroid mass that moved with swallowing, consistent with a right thyroid lesion. Ultrasound evaluation of the lump revealed a large lobulated isoechoic mass (8.1x5.4x4.3cm) with cystic areas within the right thyroid lobe. Significantly, there was also a lobulated mass (6.1x5.1x2.9cm) with similar sonographic features located posterior to the left thyroid lobe and oesophagus, which could have represented retro-tracheal extension from the right thyroid mass. Computed tomography scan revealed a large lobulated mass occupying most of the right thyroid lobe with cystic spaces. The mass extended posteriorly, displacing and compressing the oesophagus as well as the trachea with resultant significant luminal narrowing (Fig. 1). Fine-needle aspiration cytology of the right thyroid lobe showed features compatible with adenomatous goitre (Bethesda category II). Ann Acad Med Singap 2021;50:924-5 https://doi.org/10.47102/annals-acadmedsg.2021191