anaplastic thyroid carcinoma

(redirected from anaplastic carcinoma of thyroid)

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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Only one case of anaplastic carcinoma of thyroid was seen where the smears showed an isolated cells and in tissue fragments extremely pleomorphic in size and shape; small-to-giant forms; nucleus large, bizarre shapes; clumped chromatin with excessive parachromatin clearing; nucleoli large, cytoplasm abundant, pale, vacuolated, or dense.
DISCUSSION: Anaplastic carcinoma of thyroid also known as undifferentiated carcinoma is a rare aggressive tumor arising from follicular cells of the thyroid gland.
High resolution ultrasound is only 45% sensitive in diagnosing anaplastic carcinoma of thyroid with features of hypoechogenicity, irregular margins and vascularity.