title: An extremely rare case of thyroid malignancy from the non-Alpine region: Angiosarcoma.
abstract: BACKGROUND
  Thyroid angiosarcoma is a rather rare malignancy featuring a poor prognosis, and which may interfere with other aggressive thyroid tumors; it is usually seen in the Alpine region.
  
  
  METHODS
  A 74-year-old male was referred to our center with complaints of progressive neck swelling and dyspnea. He had multiple nodules featuring cystic degeneration and calcifications in the thyroid gland, together with multiple lymphadenopathies of the neck region. Fine-needle aspiration cytology (FNAC) confirmed the presence of anaplastic carcinoma. A total thyroidectomy was performed. During the postoperative period, multiple drainage were performed for recurrent hematomas, but hematoma development could not be prevented. On postoperative day 7, the patient died due to multiple-system failure. Histopathological investigation of the thyroidectomy specimen indicated that the lesion was an angiosarcoma.
  
  
  CONCLUSIONS
  The cytological diagnosis of thyroid angiosarcoma is quite difficult. Extracapsular invasion and distant organ metastasis during surgery are known as strong and negative prognostic factors for thyroid angiosarcoma. Treatment is quite difficult, since this tumor is locally aggressive, destructive, and features a high recurrence rate. In this case, since extracapsular invasion, as well as lymph node and lung metastasis were present at the time of surgery; the expected survival time was quite short.
  
  
  CONCLUSIONS
  This case shows that during differential diagnosis, patients initially diagnosed with anaplastic carcinoma via FNAC may actually present with angiosarcoma. It may be helpful to review the treatment modalities for this cancer type, which has a rather poor prognosis and features severe bleeding, as well as local and distant metastasis.
authors.affiliation: Ministry of Health, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of Otolaryngology and Head & Neck Surgery, Ankara, Turkey. Electronic address: bayiromer@hotmail.com.
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Bayır
authors.affiliation: Ministry of Health, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of Pathology, Ankara, Turkey.
authors.forename: Demet
authors.initials: D
authors.lastname: Yılmazer
authors.affiliation: Atatürk Research and Training Hospital, Department of Endocrinology, Ankara, Turkey.
authors.forename: Reyhan
authors.initials: R
authors.lastname: Ersoy
authors.affiliation: Ministry of Health, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of Pathology, Ankara, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Akca
authors.affiliation: Ministry of Health, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of Otolaryngology and Head & Neck Surgery, Ankara, Turkey.
authors.forename: Güleser
authors.initials: G
authors.lastname: Saylam
authors.affiliation: Ministry of Health, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of Pathology, Ankara, Turkey.
authors.forename: Ünsal
authors.initials: Ü
authors.lastname: Han
authors.affiliation: Ministry of Health, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of Otolaryngology and Head & Neck Surgery, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Özdek
authors.affiliation: Atatürk Research and Training Hospital, Department of Endocrinology, Ankara, Turkey.
authors.forename: Bekir
authors.initials: B
authors.lastname: Çakır
authors.affiliation: Yıldırım Beyazıt University, Medical Faculty, Department of Otolaryngology and Head & Neck Surgery, Ankara, Turkey.
authors.forename: Mehmet Hakan
authors.initials: MH
authors.lastname: Korkmaz
keywords: Head and neck malignancy; Hematoma; Primary angiosarcoma; Surgery; Thyroid gland