title: Metastatic angiosarcoma to the thyroid.
abstract: BACKGROUND
  Angiosarcoma (AS) in non-alpine areas is exceptionally rare, and so is metastatic AS to the thyroid. The difficulties and controversies associated with its diagnosis and management are highlighted in this case report.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A Chinese gentleman with AS metastatic to the thyroid presented a year after radiotherapy to his scalp AS. There was rapid expansion of the metastasis over 2 weeks and invasion of the pyriform fossa caused dysphagia and haemoptysis. The diagnosis was established by paraffin histology of the tumour post-hemithyroidectomy, after repeated fine-needle aspiration cytology was not diagnostic. Patient opted for external beam radiotherapy to the pyriform fossa instead of pharyngolaryngectomy. Residual pyriform tumour was treated with brachytherapy delivered via nasogastric tube. Unfortunately, the patient died 4 months later due to cardiac failure which was unrelated to his oncologic condition.
  
  
  CONCLUSIONS
  AS metastatic to the thyroid is possible. The unexpectedly acute presentation and difficulties associated with diagnosis and management are highlighted. A useful method of delivering brachytherapy to the pyriform fossa is described.
authors.affiliation: Changi General Hospital, Department of Otolaryngology, Head & Neck Surgery, 2 Simei Street 3, Singapore 529889, Singapore. soh_ping_eng@cgh.com.sg
authors.forename: S P
authors.initials: SP
authors.lastname: Eng
authors.forename: C H K
authors.initials: CH
authors.lastname: Goh
authors.forename: J B K
authors.initials: JB
authors.lastname: Khoo
authors.forename: T L
authors.initials: TL
authors.lastname: Yang
authors.forename: L H Y
authors.initials: LH
authors.lastname: Lim
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D006394:Hemangiosarcoma / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008297:Male; D013964:Thyroid Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D013965:Thyroidectomy