Anaplastic Thyroid Carcinoma: The Great Masquerader

Anaplastic thyroid carcinoma (ATC) has been regarded as the rarest form of thyroid malignancy, which entails around 2% of thyroid malignancies. It traditionally presents with rapidly enlarging anterior neck swelling with obstructive symptoms. Due to its rich blood supply and lymphatic drainage, the thyroid gland is resistant to infection. Parallel to that, the presentation of thyroid abscess frequently points towards an underlying upper respiratory tract infection. We present a case involving an elderly female presenting with a thyroid abscess, which later turned out to be ATC following a histopathological diagnosis of the thyroid gland. The initial cytology workout was negative for malignancy. We highlight the relatively uncommon presentation along with its management.