Surgical Management of Anaplastic Thyroid Carcinoma

Abstract

The treatment of patients with anaplastic thyroid cancer, like the treatment of patients with papillary thyroid cancer, is controversial. The reason for the controversy is that anaplastic carcinoma is one of the most aggressive and potentially deadly malignancies. Most patients with anaplastic thyroid cancer have a poor prognosis regardless of treatment and usually die of suffocation from local tumor invasion; the median survival time is about 6 mo (1,2), and the overall mortality rate is about 97% (1–3). At initial examination, patients usually have a large (5–10 cm) fixed mass, and about 30% will already have distant, usually pulmonary, metastases (1,4). Most patients with anaplastic thyroid cancer will also have coexistent well-differentiated thyroid cancer (4–7). Apparently, 1% of differentiated thyroid cancers transform into anaplastic cancers (8). Some of these tumors demonstrate progression from well-differentiated papillary cancers through the insular variant, then into anaplastic cancer (9). Serial transplantation of differentiated thyroid tumors also leads to anaplastic transformation (10,11). Anaplastic thyroid cancers are more likely to have p53 and platelet-derived growth factor mutations than differentiated thyroid cancers (12–14).KeywordsThyroid CancerThyroid CarcinomaPapillary Thyroid CarcinomaPapillary Thyroid CancerDifferentiate Thyroid CancerThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.