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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References in periodicals archive ?
Dehghani, "Diffuse large B cell lymphoma of thyroid as a masquerader of anaplastic carcinoma of thyroid, diagnosed by FNA: a case report," CytoJournal, vol.
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.
(7) There are three patterns of anaplastic carcinoma of thyroid in cytology- spindle cell (53%), giant cell (50%) and squamoid (19%).