A 51-year-old woman came with difficulty in swallowing solids since 20 days
Contrast enhanced CT scan of the neck shows a heterogeneously enhancing soft tissue measuring approximately 7 x 4 x 3 cm in the retropharyngeal space involving the undersurface of epiglottis, aryepiglottic folds, pyriform sinuses, Posteriorly, it involves the cervical esophagus and extends along its length upto the mediastinum. There is central necrotic component with air foci. There is erosion of the posterosuperior aspect of the cricoid cartilage. The supraglottic airway is compromised.
The thyroid gland is bulky and heterogeneous with multiple hypodense areas
In the neck, there are enlarged necrotic lymph nodes, few of them showing conglomeration. There is an osteolytic lesion with an enhancing soft tissue component measuring 3.2 x 2 cm in the right occipital bone indenting on the dura - but not - breaching it.