Sudden enlargement of the neck

A 63‐year‐old man with a history of multinodular goitre presented with a sudden enlargement of the neck associated with dysphagia and dysphonia for 3 weeks (Figure, A). Examination revealed a major thyroid nodule, with a normal thyroid stimulating hormone level. Thyroid ultrasonography showed a right cystic nodule over 12 cm in size (Figure, B).

Computed tomography scan showed tracheal deviation and compression (Figure, C and D). Fine‐needle aspiration was performed to improve the patient's symptoms, removing more than 100 mL of a dark liquid. Total thyroidectomy revealed a benign multinodular goitre.

Sudden haemorrhagic infarction or haemorrhage of a thyroid nodule can cause a predominantly cystic neck mass, which can be associated with compressive symptoms (eg, dysphonia, dysphagia or dyspnoea).