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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The definitive distinction between thyroid lymphoma and anaplastic thyroid carcinoma is traditionally made via an open biopsy and histopathologic examination.
PET-CT staging and post-therapeutic monitoring of anaplastic thyroid carcinoma.
Particular attention was also paid to the tracheostomy site, which is a common place of recurrence with anaplastic thyroid carcinoma.
Like differentiated thyroid carcinoma, anaplastic thyroid carcinoma is more common in women than men by a margin of 3:1.
1,7) Some authors have recommended that insular carcinoma be classified as a poorly differentiated thyroid tumor that is less aggressive than undifferentiated or anaplastic thyroid carcinoma, while others have suggested that insular carcinoma is an aggressive variant of a well-differentiated thyroid cancer that manifests insular features.
Of the 29 efficacy evaluable patients, one patient with anaplastic thyroid carcinoma had a partial response, one patient with hormone refractory prostate cancer demonstrated a confirmed partial PSA response, and 18 patients had disease stabilization.
In Phase I trials, CA4P demonstrated biological effect with a complete patient response in anaplastic thyroid carcinoma and a partial response in fibrosarcoma.
One patient, a 55-year-old man with anaplastic thyroid carcinoma, had a "pathological complete remission" after undergoing CA4P treatment and has been disease free for more than two years.
Thyroid lymphoma should also be differentiated from Hashimoto's thyroiditis and from undifferentiated or anaplastic thyroid carcinomas whose management and prognosis are totally different.
Thyroid cancer is classified into four main histology groups: papillary (PTC), follicular (FTC), medullary (MTC), and undifferentiated or anaplastic thyroid carcinomas.
Genetic alterations involved in the transition from well-differentiated to poorly differentiated and anaplastic thyroid carcinomas.
Poorly differentiated and anaplastic thyroid carcinomas can arise de novo or from the preexisting well-differentiated papillary or follicular carcinoma.