Abstract
Simple SummaryThe therapeutic strategies employed for anaplastic thyroid cancer patients seems to be insufficient to prolong their survival, but some characteristics could predict a good prognosis, so that, starting from our experience we offer a systematic review of the literature to better understand anaplastic thyroid cancers behavior and their prognostic factors, in order to recognize and select the patients with the higher probability of better outcome even if metastatic. Moreover, we described an uncommon site of metastasis in order to improve scientific knowledge about this rare and highly aggressive pathology.Anaplastic thyroid carcinoma (ATC) is a very rare, highly aggressive malignant thyroid tumor with an overall survival from 3 to 5 months in most of the cases. Even the modern and intensive treatments seem not to be enough to provide a cure, also for the resectable ones, and the role of chemotherapy is still unclear but does not seem to prolong survival. Nevertheless, some patients survive longer and have a better outcome, even in the presence of metastasis, than what the literature reports. We present the case of a 64-year-old female affected by ATC, treated on February 2018 with surgery followed by chemoradiation. One year after surgery, the patient developed a subcutaneous recurrence that was radically resected and is still alive 29 months after the diagnosis. We propose a systematic review of the literature to deepen the knowledge of the prognostic factors of ATC with the aim to recognize and select the patients with a better outcome, even if metastatic, and to describe a very uncommon site of metastatization.
Highlights
Anaplastic thyroid carcinoma (ATC) is a rare neoplasm, representing about 1–2% of all thyroidal malignancies, with a mean age at diagnosis between 55 and 65 years [1,2,3]; it contributes up to 14–50% of thyroid cancer-related deaths.About 25% of ATC patients had a thyroid goiter and 10% had a family history of goiter
In order to identify all potentially relevant scientific papers published until July 2020 and reporting original research on the survival and uncommon sites of metastasis of ATC, a systematic search of the Medline databases was carried based on the following criteria:
Full text papers; Available abstracts; Papers written in English; Clinical studies, reviews and case reports related to a prolonged survival compared to the literature data; Clinical studies, reviews and case reports related to uncommon sites of metastasis compared to the literature data; Clinical studies, reviews and case reports on survival prognostic and predictive factors
Summary
About 25% of ATC patients had a thyroid goiter and 10% had a family history of goiter. It is more common in places with endemic goiter due to iodine deficiency. Most ATC patients present with a thyroid mass (77%) followed by a node mass (54%), dysphagia (40%) and neck pain (26%). It is a very aggressive malignancy that arises from follicular cells of the thyroid gland, with rapid growth and radio- and chemo-resistance; yet, even if it leads to a median survival of 3–10 months [4], some patients reach a longer survival, demonstrating that little is still known about these tumors.
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