A 72-year-old woman came with a swelling in the neck since one year. It had increased in size recently and was associated with difficulty in swallowing and fever for five days.
Frontal and lateral radiographs of the neck show a well-defined soft tissue swelling with an air fluid level in the anterior and left lateral aspect of the neck displacing and compressing the trachea. Contrast enhanced CT scan of the neck shows a large, peripherally enhancing collection with air in the left lobe of the thyroid.