The combined intrathyroidal course of the brachiocephalic artery, right common carotid artery and right subclavian artery

Purpose: We present an extremely rare vascular variant in which the brachiocephalic artery, right common carotid artery, and right subclavian artery course through the right lobe of the thyroid gland. Methods: A 54-year-old woman underwent a coronary computed tomography (CT) angiography examination with the suspicion of infective endocarditis. Results: Unexpectedly, the distal brachiocephalic artery, the proximal right common carotid artery, and right subclavian artery had a course through the right lobe of the thyroid gland. Otherwise, the arcus aorta branching pattern was normal. Conclusion: The supraaortic major branches seldom have intrathyroidal course. The intrathyroidal course of the right common carotid artery was described previously only in one case. But, to our best knowledge, the combined intrathyroidal course of these three major vessels has not been previously reported. Although asymptomatic, such variations may complicate lower neck procedures involving thyroidectomies and thyroid biopsies if undetected and unreported. So, the awareness of this atypical course while reporting CT examinations is crucial prior to neck interventions.