Fistulized thyroid abscess revealing esophageal carcinoma in a young adult

Abstract

Thyroid abscess is an extremely rare condition. Its diagnosis is often late, which predisposes to serious complications. We report a case of thyroid abscess in a young adult who presented to the emergency room for a basi-cervical swelling associated with dysphonia, dysphagia and dyspnea. Neck ultrasound showed a collection of left thyroid lobe. A cervicothoracic computed tomography objectified an abcess of the left lobe of the thyroid fistulising in the hyoid muscles beneath and left piriform sinus with thickening of the hypopharynx and upper esophageal sphincter. The puncture brought a purulent fluid. Panendoscopy revealed the presence of a tumor proliferation of the upper esophageal sphincter. A biopsy with histological examination concluded to a squamous cell carcinoma. This observation indicates that the thyroid abscess may be the mode of discovery of esophageal cancer. Hence the interest to seek an underlying cause in cases of thyroid abscess.