Angiosarcoma of the thyroid.

Hemangiosarcoma of the thyroid gland is a very rare entity. The therapy of this tumor is difficult because of its locally aggressive and destructive behavior with a high recurrence rate. We report a case of 60-year-old man with history of 1 month rapidly enlarging neck mass in the thyroid region. Ultrasound examination and CT scan showed resistance arising from the left thyroid lobe. FNAC revealed necrotic tumor mass without any cytological specification. Because of the clinical findings, a total thyroidectomy was indicated. The surgery was complicated by invasion of the tumor mass into the surrounding tissues. Therefore, only left side hemithyroidectomy was performed. Histopathology including histochemistry proved positive staining for Factor VIII, Fasciin, and CD31 in tumor cells. In this case, adjuvant oncological treatment was planned, but the patient died because of massive bleeding from the tumor mass. The histological diagnosis of thyroid hemangiosarcoma is mostly difficult. The treatment of the first choice is radical surgery. If the tumor cannot be treated by surgery, then radiotherapy, eventually chemotherapy is indicated. The prognosis is not favorable.