Abstract
Anaplastic thyroid carcinoma is fatal if unresectable. However, improved survival has been reported after gross total resection and multimodality therapy. In this report, we describe the contrast-enhanced high-resolution CT characteristics of anaplastic thyroid carcinoma in 57 patients. Anaplastic thyroid carcinoma presented as a large neck mass with necrosis in 82% of cases. The tumors demonstrated common extrathyroidal extension (91%). Sixty-two percent of tumors demonstrated calcification. Visceral space invasion involved the esophagus (62%), trachea (57%), and larynx (29%). Carotid artery encasement was present in 42%, and 43% involved the internal jugular vein. Sixty-three percent had lateral compartment lymphadenopathy; 58% of these nodes were necrotic, and 11% were cystic. No metastatic nodes had calcification. Central compartment lymphadenopathy was seen in 56% of cases, and lateral retropharyngeal lymphadenopathy was detected in 12%. Knowledge of these imaging features aids in guiding the approach to the initial tissue diagnosis with either fine-needle aspiration or core biopsy, assessing the feasibility of surgical resection, and determining prognosis.
Highlights
The purpose of our study was to accurately describe the contrast-enhanced CT (CECT) features of Anaplastic thyroid carcinoma (ATC) at presentation in a large number of patients presenting to a tertiary cancer referral center
ATC carries a dismal prognosis, improved survival can be achieved in select cases with a gross total resection in combination with chemotherapy/targeted therapy and radiation therapy
Laryngotracheal and esophageal resections may be considered for less biologically aggressive tumors, these more complex surgeries and reconstructions are rarely attempted for patients with ATC because of the morbidity of the surgery in the setting of an overall very poor prognosis
Summary
The purpose of our study was to accurately describe the CECT features of ATC at presentation in a large number of patients presenting to a tertiary cancer referral center
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