Cytodiagnosis of a Metastatic Anaplastic Carcinoma of Thyroid Presenting as Multiple Subcutaneous Nodules

Anaplastic thyroid carcinoma (ATC) is a rare malignancy with highly aggressive behavior. It has an overall survival from 3 to 5 months in most of the cases. The most common metastatic sites are the lungs, followed by the intrathoracic and neck lymph nodes. Soft-tissue involvement is extremely rare and only a few cases have been published in English literature. Here, we report a case of ATC in a 22-year-old male who presented in early decade of life with multiple soft-tissue metastases as a rare initial presentation. Clinical examination revealed a diffusely enlarged thyroid gland, cervical lymphadenopathy, and multiple subcutaneous nodules over left thigh, chest and abdominal wall. Cytology from all sites of lesions followed by cell block with immunohistochemistry confirmed a diagnosis of ATC with nodal and cutaneous metastases. The patient succumbed to death before further management.