Abstract

A 74 year old male patient with the history of hypertension, diabetes mellitus and 50 years of nodular thyroid presented at the emergency unit with shortness of breath, and pleural effusion was detected after physical and laboratory examination. Imaging studies demonstrated bilateral pleural fluid, slightly more in the left and several intrapulmonary nodules. The patient died of cardiac arrest at the 4th day of hospitalization. At autopsy, hemorrhagic fluid in the thoracic cavity and hemorrhagic nodules on the right and left pleural surfaces were detected. On microscopic examination of the hemorrhagic cystic nodules of left thyroid lobe and pulmonary nodules; anastomosing angiomatous structures formed by large fusiform epitheloid cells and large eosinophilic cytoplasm, showing partial papillary or solid islet structures were observed. In the immunohistochemical, examination, staining was negative for cytokeratin and thyroglobulin and positive for CD31 CD34 and F VIII. Based on these findings, the case was diagnosed as “thyroid angiosarcoma and multiple pleuropulmonary metastasis”.