anaplastic thyroid carcinoma

Anaplastic thyroid carcinoma is a highly aggressive form of thyroid cancer and accounts for ~1-2% of primary thyroid malignancies. Of all the subtypes, this carries the worst prognosis.

Epidemiology

Typically occurs in the elderly with the peak incidence in the 6 and 7decades. A significant proportion of patients may have a history of concurrent multinodular goiter. There is a recognized female predilection .

Clinical presentation

Patients tend to present late. Compressive symptoms of neighboring structures are common.

Radiographic features

Ultrasound

May show microcalcification . Usually seen as an infiltrative lesion.

CT

CT is useful for assessment of extrathyroidal tumor invasion  as well as regional lymph node and distant metastatic involvement, which are commonly found at the time of CT assessment .

The primary tumor typically appears as a highly infiltrative mass about the thyroid gland.

Nuclear imaging
  • radioiodine: usually has no uptake .

Treatment and prognosis

The prognosis is very poor, with 5-year survival ~5% and considered invariably fatal . These tumors are automatically considered stage IV disease by the TNM staging system.

Differential diagnosis

Consider other infiltrative thyroid neoplasms, such as:

See also

Siehe auch:
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