Fig1

Anterior cervical mass and MR enhanced imaging (coronal view) of thyroid gland A: Physical examination showed a giant mass in the anterior neck; B: MR enhanced imaging showed a large thyroid mass with tracheal deviation.

Fig2

MR enhanced imaging (transverse view) of thyroid gland and CT imaging of trachea A: MR enhanced imaging showed the right lobe of the thyroid gland was significantly occupied, and the trachea was pushed to the left; B: CT imaging of trachea showed the oropharynx, laryngopharynx and trachea were compressed and displaced; arrow showed the narrowest airway was only 4.28 mm.

Fig3

MR enhanced imaging of liver The imaging showed hepatic tumor with retroperitoneal lymph node metastasis.

Fig4

Postoperative pathology and HE images Immunohistochemistry showed metastatic nodules consistent with HCC：alpha-fetoprotein(AFP)(+), Galectin-3(+),thyroid peroxidase(TPO)(-), hector battifora mesothelial epitope(HBME)-1(-), cytokeratin(CK)19(-), CK8(+), CK18(+), Galectin-3(+), cluster of differentiation(CD31)(+), CD34(+), ETS-related gene(ERG)(+), Ki-67(25%+); special stains: reticulin stain (-).