Death due to external compression of the trachea in a patient with multinodular hemorrhagic goiter

Spontaneous hemorrhagic thyroid nodule: a case report and review of the literature

Spontaneous hemorrhage within thyroid nodules is infrequent and challenging to manage. Patients with this condition typically manifest acute neck pain, swelling, and discomfort. This report details a rare case of a 49-year-old male patient who was not known to have any history of thyroid disease. He presented with a distinctive clinical scenario of a spontaneous hemorrhagic thyroid nodule that was managed surgically and had a satisfying outcome. In addition, we have conducted a review of the literature regarding the clinical presentation, diagnosis, and outcomes of published cases in correlation with our discussed case.

A Rare Case of Fatal Thyroid Hemorrhage After Fine-Needle Aspiration: Case Report and Review of the Literature

ABSTRACT

Sudden death due to massive hemorrhage after a mini-invasive ambulatory diagnostic procedure is extremely rare. Fine-needle aspiration (FNA) of thyroid nodules is very safe, displaying a low rate of complications, all of which mild and often self-limiting. In few cases do these complications necessitate surgical decompression, and rarely does FNA of a thyroid nodule lead to the death of the patient.We report a case of sudden death caused by respiratory insufficiency after compression of the vascular and nervous structures of the neck and obstruction of the upper airways by hemorrhages dissecting the thyroidal and perithyroidal tissues in a 78-year-old woman. These hemorrhages were the result of vascular lacerations caused during diagnostic FNA of a nodule suspected of malignancy. In such cases, it is important to conduct a complete autopsy and histological analysis to ascertain the origin of massive hemorrhage involving the structures of the neck and to attribute the cause of death to the aforementioned procedure. The forensic pathologist must bear in mind that even extremely small damage, such as that produced by a fine needle, may cause a fatal hemorrhage in subjects with a subverted anatomo-pathological picture (such as, for example, the massive fibrosis of an organ).

Variable Mechanisms of Sudden and Unexpected Death in Cases of Occult Carcinoma of the Larynx

ABSTRACT

Two cases of clinically undiagnosed laryngeal squamous cell carcinomas in men aged 57 and 66 years, respectively, are reported that resulted in sudden death from upper airway occlusion. The cause of the terminal event differed between the 2 cases with acute airway narrowing being precipitated by tenacious mucopurulent secretions in case 1 and hemorrhage from surface ulceration with glottic occlusion by blood clot in case 2. At autopsy, the immediate cause of acute airway compromise in cases of space-occupying laryngeal lesions may, therefore, be due to the synergistic effects of different factors.