Airway management of thyroid malignancy with cervical spine metastasis for a two-stage dual procedure; Discretion dictates never burn your bridges

Thyroid swellings are a known cause of airway obstruction and potentially difficult intubation due to compression and deviation of the trachea. We encountered a unique challenging case of a malignant retrosternal goitre compressing the trachea, with cervical spine metastasis causing paresthesia and weakness in all four limbs, for a two-stage dual procedure, embolisation and excision of thyroid, and embolisation and fixation of the cervical spine.