anaplastic thyroid carcinoma


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anaplastic thyroid carcinoma

The most aggressive of all thyroid malignancies, which accounts for only 2–5% of thyroid carcinomas but 40% of thyroid cancer-related deaths. The typical history is of a rapid increase in size of a long-standing cold thyroid nodule in an elderly patient; it is more common in iodine-deficient geographic regions and in a background of prior thyroid pathology (e.g., goitre or thyroid cancer); up to 80% have a history of well- (papillary, follicular) or poorly differentiated thyroid carcinoma. Local invasion (e.g., trachea, oesophagus) is common.

Clinical findings
Hoarse voice, cough, haemoptysis, tracheal obstruction; physical exam may reveal nodules in thyroid.

Lab
Thyroid function is usually normal.

Diagnosis
Biopsy.
 
Management
Generally palliative; 50% are inoperable at the time of diagnosis; surgery, radiation and chemotherapy are essentially useless.

Prognosis
Anaplastic carcinoma is an aggressive disease with early metastases in lung (50% of cases), bone and brain; median survival is 4­–6 months.
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References in periodicals archive ?
Undifferentiated anaplastic thyroid carcinoma is a rare and underreported condition in the setting of chronic hyperthyroidism.
Mellone et al., "Nuclear factor-?b contributes to anaplastic thyroid carcinomas through upregulation of miR-146a," The Journal of Clinical Endocrinology and Metabolism, vol.
Anaplastic thyroid carcinoma is documented as one of the most rapid growing malignant tumors with a median overall survival of 6 months or less7.
Anaplastic thyroid carcinoma shows a marked epithelial-mesenchymal transition (EMT) [25, 26], generating cell with stem-like characteristic.
RSV suppressed anaplastic thyroid carcinoma cell growth via S-phase cellcycle arrest and apoptosis; it induced functional Notch1 protein expression and activated the pathway by transcriptional regulation [36].
Anaplastic thyroid carcinoma (ATC) is rare, representing only 1-2% of all thyroid cancers, but nevertheless accounts for up to 50% of all thyroid cancer deaths [1-6].
Suzuki, "Prognostic factors and treatment outcomes for anaplastic thyroid carcinoma: ATC research consortium of Japan Cohort Study of 677 patients," World Journal of Surgery, vol.
Jean Woods, 49, was told she had only months to live when she was diagnosed with terminal anaplastic thyroid carcinoma.
There was only one mortality in the series where the cause of death was advanced primary tumor (anaplastic thyroid carcinoma).
In solid tumors, the product has demonstrated potent and selective activity against tumor vasculature, as well as clinical activity against anaplastic thyroid carcinoma (ATC), ovarian and other types of cancer.
Anaplastic thyroid carcinoma has also been associated with Graves' disease however, it is even less frequently reported than the papillary type (3).
Finally, the protein product of PAX8/ PPARG acts, at least in part, by inhibiting wild-type PPARG signaling (8), suggesting that such tumors could be amenable to PPARG agonist therapy, similar to what has been observed in anaplastic thyroid carcinoma (9).