Acute airway obstruction caused by goiter hemorrhage is a rare but potentially life-threatening condition. We report a case of nodular goiter in which spontaneous rupture with active bleeding developed suddenly, presenting as a large neck mass with dyspnea. Sonographic examination revealed a large inhomogeneous soft tissue mass in the left thyroid lobe containing some hypoechoic areas. Color Doppler and spectral Doppler analysis were consistent with a large hematoma and pseudoaneurysm, which was subsequently confirmed at surgery.
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