Abstract
BackgroundAnaplastic thyroid carcinoma is a rare, rapidly progressive, and highly aggressive tumor. It has a global annual incidence of 1–2 per million people. It mostly affects older adults and women. The median survival duration after diagnosis does not exceed 6–8 months.Case presentationA 60-year-old female patient of mixed race (Honduran) presented to the local medical service with dysphonia that had started approximately 2 months earlier, accompanied by orthopnea that had started 1 month earlier. On physical examination, a soft mass was palpated within the anterior neck region; it was approximately 4 cm in diameter, painless, and mobile on swallowing, and had irregular margins. Ultrasound and computed tomography of the neck were performed. Subsequently, fine needle aspiration biopsy was performed. The histological diagnosis was anaplastic thyroid carcinoma (stage IVB). She underwent total thyroidectomy and chemotherapy. She is currently in her fifth year of remission after diagnosis and remains under oncologic surveillance.DiscussionAnaplastic thyroid carcinoma demonstrates a lethal behavior. Approximately 18% survive for more than a year after diagnosis, and 0–10% survive for 5 years. Different pretherapeutic prognostic factors may affect survival, including age < 70 years, the absence of distant metastases, and complete local resection.ConclusionConventional treatment improves the quality of life of the patient, but the results are not encouraging for the medium and long term. Only a few patients manage to exceed the average life expectancy of 3–6 months, despite undergoing the currently available therapeutic regimen.
Highlights
Anaplastic thyroid carcinoma is a rare, rapidly progressive, and highly aggressive tumor
Anaplastic thyroid carcinoma (ATC) is a rare undifferentiated neoplasm characterized by a sudden onset and rapid progression
Case presentation We present the case of a 60-year-old female patient of mixed race (Honduran) from an urban area of Honduras, with a pathological history of arterial hypertension and type 2 diabetes mellitus under control
Summary
ATC is one of the most aggressive cancers, and is responsible for up to half of all deaths caused by thyroid cancers. In a multicenter retrospective study conducted in Germany, it was concluded that the pretherapeutic prognostic factors underlying long-term survival were age < 70 years, the absence of distant metastases, and complete local resection [11] Our patient had these three prognostic factors: she was 60 years old, did not have distant metastases, and even though she had local invasion of perithyroid soft tissues and lymph nodes, complete resection of the tumor was successfully performed. The tumor in our patient adhered to the perithyroid muscles and regional lymph nodes, and was graded as stage IVb. Wendler et al [11] conducted a multicenter study of 100 patients diagnosed with ATC between 2000 and 2015 at five German referral centers; they demonstrated that survival associated with ATC, independent of treatment, is related to the stage. The tumor was successfully resected surgically, and our patient had favorable survival, no recurrence, and a significantly improved quality of life [13]
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