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Concept
Anaplastic thyroid cancer
Summary
Anaplastic thyroid cancer (ATC), also known as anaplastic thyroid carcinoma, is an aggressive form of thyroid cancer characterized by uncontrolled growth of cells in the thyroid gland. This form of cancer generally carries a very poor prognosis due to its aggressive behavior and resistance to cancer treatments. The cells of anaplastic thyroid cancer are highly abnormal and usually no longer resemble the original thyroid cells and have poor differentiation.
ATC is an uncommon form of thyroid cancer only accounting for 1-2% of cases, but due to its high mortality, is responsible for 20-50% of deaths from thyroid cancer. The median survival time after diagnosis is three to six months. Some studies report that 10% to 15% survive more than 1 year; 3-year and 5-year survival is very rare. It occurs more commonly in women than in men and is seen most commonly in people ages 40 to 70.
Anaplastic thyroid cancer typically manifests as a rapidly enlarging neck mass. Associated redness and swelling of the overlying skin sometimes occur. ATC commonly causes symptoms by compressing local structures, such as the esophagus, carotid arteries, recurrent laryngeal nerve, and trachea. This compression of local anatomic structures may cause symptoms such as difficulty controlling the voice, hoarseness, difficulty swallowing, or trouble breathing. Other symptoms include cough, neck pain, or symptoms from the spread of cancer to distant sites in the body, such as the brain. ATC may rarely present with coughing up blood.
Risk factors include: age > 60, long standing goiter, and exposure to chest radiation.
Nearly half of ATC cases occur in the setting of coexisting differentiated thyroid cancer. This suggests that many ATC cases have dedifferentiated from differentiated thyroid cancer and, as a result, become more aggressive and difficult to treat. Differentiated thyroid cancer is seen coexisting with ATC on fine-needle aspiration biopsies in 20-50% of cases.
Anaplastic tumors have a high mitotic rate and frequently invades the local blood and lymphatic vessels.
Official source
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