Abstract

Aim: Among the endocrine malignancies, thyroid carcinoma (TC) is the most common. However, anaplastic TC accounts for 1-2% of these cancers. The aim of this study was to evaluate the demographic and pathologic features, treatments, and survival of patients with anaplastic TC.

Methods: Anaplastic TC patients who applied to our medical oncology clinics between 01.01.2012 -01.12.2018 were retrospectively evaluated.

Results: A total of 8 patients were included in the study. There were 4 female and 4 male patients with a median age of 68 (minimum 61-maximum 83) years. The initial complaint of all patients was a fast-growing swelling in the neck. Six patients had total thyroidectomy. Two patients had anaplastic TC with a differential TC. Six patients were at stage 4C. The most common site of metastasis was the lung (75%). Five patients had received a median of 3 (1-6) cycles of chemotherapy. Radiotherapy was applied to 7 patients. All patients except one died during the follow-up period. The median survival time of the patients was 3 (2-15) months.

Conclusion: Anaplastic TC, an aggressive tumor with high metastasic potential, has no effective treatment at present. Effective treatments are needed for this rare and aggressive disease. Developments in the molecular field are promising for the treatment of ATC.

Keywords: anaplastic thyroid carcinoma, overall survival, thyroid

Copyright and license

Copyright © 2024 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Küçüköztaş N, Taslamacıoğlu Duman T, Erdoğan Düzcü S, Rahatlı S, Üyetürk Ü. Anaplastic thyroid carcinoma case series. Northwestern Med J. 2024;4(1):34-40. https://doi.org/10.54307/2024.NWMJ.86

References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020; 70(1): 7-30. https://doi.org/10.3322/caac.21590
  2. Kitahara CM, Sosa JA. The changing incidence of thyroid cancer. Nat Rev Endocrinol. 2016; 12(11): 646-53. https://doi.org/10.1038/nrendo.2016.110
  3. Prete A, Borges de Souza P, Censi S, Muzza M, Nucci N, Sponziello M. Update on Fundamental Mechanisms of Thyroid Cancer. Front Endocrinol (Lausanne). 2020; 11: 102. https://doi.org/10.3389/fendo.2020.00102
  4. Molinaro E, Romei C, Biagini A, et al. Anaplastic thyroid carcinoma: from clinicopathology to genetics and advanced therapies. Nat Rev Endocrinol. 2017; 13(11): 644-60. https://doi.org/10.1038/nrendo.2017.76
  5. Lin B, Ma H, Ma M, et al. The incidence and survival analysis for anaplastic thyroid cancer: a SEER database analysis. Am J Transl Res. 2019; 11(9): 5888-96.
  6. Wächter S, Vorländer C, Schabram J, et al. Anaplastic thyroid carcinoma: changing trends of treatment strategies and associated overall survival. Eur Arch Otorhinolaryngol. 2020; 277(5): 1507-14. https://doi.org/10.1007/s00405-020-05853-8
  7. Perrier ND, Brierley JD, Tuttle RM. Differentiated and anaplastic thyroid carcinoma: Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 2018; 68(1): 55-63. https://doi.org/10.3322/caac.21439
  8. Chiacchio S, Lorenzoni A, Boni G, Rubello D, Elisei R, Mariani G. Anaplastic thyroid cancer: prevalence, diagnosis and treatment. Minerva Endocrinol. 2008; 33(4): 341-57.
  9. Keutgen XM, Sadowski SM, Kebebew E. Management of anaplastic thyroid cancer. Gland Surg. 2015; 4(1): 44-51. https://doi.org/10.3978/j.issn.2227-684X.2014.12.02
  10. Smallridge RC, Ain KB, Asa SL, et al. American Thyroid Association guidelines for management of patients with anaplastic thyroid cancer. Thyroid. 2012; 22(11): 1104-39. https://doi.org/10.1089/thy.2012.0302
  11. Jin M, Jakowski J, Wakely PE. Undifferentiated (anaplastic) thyroid carcinoma and its mimics: a report of 59 cases. J Am Soc Cytopathol. 2016; 5(2): 107-15. https://doi.org/10.1016/j.jasc.2015.08.001
  12. Suh HJ, Moon HJ, Kwak JY, Choi JS, Kim EK. Anaplastic thyroid cancer: ultrasonographic findings and the role of ultrasonography-guided fine needle aspiration biopsy. Yonsei Med J. 2013; 54(6): 1400-6. https://doi.org/10.3349/ymj.2013.54.6.1400
  13. Untch BR, Olson JA. Anaplastic thyroid carcinoma, thyroid lymphoma, and metastasis to thyroid. Surg Oncol Clin N Am. 2006; 15(3): 661-79. https://doi.org/10.1016/j.soc.2006.05.006
  14. Seethala RR, Nikiforov YE. Anaplastic (undifferentiated) carcinoma. In: Diagnostic Pathology and Molecular Genetics of the Thyroid: A Comprehensive Guide for Practicing Thyroid Pathology. Nikiforov YE, Biddinger PW, Thompson LDR, editors. Lippincott Williams & Wilkins, Philadelphia, PA; 2009: 228-48.
  15. Maatouk J, Barklow TA, Zakaria W, Al-Abbadi MA. Anaplastic thyroid carcinoma arising in long-standing multinodular goiter following radioactive iodine therapy: report of a case diagnosed by fine needle aspiration. Acta Cytol. 2009; 53(5): 581-3. https://doi.org/10.1159/000325388
  16. Sniezek JC, Holtel M. Rare tumors of the thyroid gland. Otolaryngol Clin North Am. 2003; 36(1): 107-15. https://doi.org/10.1016/s0030-6665(02)00134-2
  17. Are C, Shaha AR. Anaplastic thyroid carcinoma: biology, pathogenesis, prognostic factors, and treatment approaches. Ann Surg Oncol. 2006; 13(4): 453-64. https://doi.org/10.1245/ASO.2006.05.042
  18. Moretti F, Farsetti A, Soddu S, et al. p53 re-expression inhibits proliferation and restores differentiation of human thyroid anaplastic carcinoma cells. Oncogene. 1997; 14(6): 729-40. https://doi.org/10.1038/sj.onc.1200887
  19. Quiros RM, Ding HG, Gattuso P, Prinz RA, Xu X. Evidence that one subset of anaplastic thyroid carcinomas are derived from papillary carcinomas due to BRAF and p53 mutations. Cancer. 2005; 103(11): 2261-8. https://doi.org/10.1002/cncr.21073
  20. Demeter JG, De Jong SA, Lawrence AM, Paloyan E. Anaplastic thyroid carcinoma: risk factors and outcome. Surgery. 1991; 110(6): 956-61.
  21. Walczyk A, Kopczyński J, Gąsior-Perczak D, et al. Poorly differentiated thyroid cancer in the context of the revised 2015 American Thyroid Association Guidelines and the Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System (eighth edition). Clin Endocrinol (Oxf). 2019; 91(2): 331-9. https://doi.org/10.1111/cen.13910
  22. Sugitani I, Miyauchi A, Sugino K, Okamoto T, Yoshida A, Suzuki S. Prognostic factors and treatment outcomes for anaplastic thyroid carcinoma: ATC Research Consortium of Japan cohort study of 677 patients. World J Surg. 2012; 36(6): 1247-54. https://doi.org/10.1007/s00268-012-1437-z
  23. Amin MB, Greene FL, Edge SB, et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging. CA Cancer J Clin. 2017; 67(2): 93-9. https://doi.org/10.3322/caac.21388
  24. Milano AF. Thyroid Cancer: 20-Year Comparative Mortality and Survival Analysis of Six Thyroid Cancer Histologic Subtypes by Age, Sex, Race, Stage, Cohort Entry Time-Period and Disease Duration (SEER*Stat 8.3.2) A Systematic Review of 145,457 Cases for Diagnosis Years 1993-2013. J Insur Med. 2018; 47(3): 143-58. https://doi.org/10.17849/insm-47-03-143-158.1
  25. Subbiah V, Kreitman RJ, Wainberg ZA, et al. Dabrafenib and Trametinib Treatment in Patients With Locally Advanced or Metastatic BRAF V600-Mutant Anaplastic Thyroid Cancer. J Clin Oncol. 2018; 36(1): 7-13. https://doi.org/10.1200/JCO.2017.73.6785
  26. Baek SK, Lee MC, Hah JH, et al. Role of surgery in the management of anaplastic thyroid carcinoma: Korean nationwide multicenter study of 329 patients with anaplastic thyroid carcinoma, 2000 to 2012. Head Neck. 2017; 39(1): 133-9. https://doi.org/10.1002/hed.24559
  27. Rao SN, Zafereo M, Dadu R, et al. Patterns of Treatment Failure in Anaplastic Thyroid Carcinoma. Thyroid. 2017; 27(5): 672-81. https://doi.org/10.1089/thy.2016.0395
  28. Pezzi TA, Mohamed ASR, Sheu T, et al. Radiation therapy dose is associated with improved survival for unresected anaplastic thyroid carcinoma: Outcomes from the National Cancer Data Base. Cancer. 2017; 123(9): 1653-61. https://doi.org/10.1002/cncr.30493
  29. Subbiah V, Puzanov I, Blay JY, et al. Pan-Cancer Efficacy of Vemurafenib in BRAFV600-Mutant Non-Melanoma Cancers. Cancer Discov. 2020; 10(5): 657-63. https://doi.org/10.1158/2159-8290.CD-19-1265
  30. Drilon A, Laetsch TW, Kummar S, et al. Efficacy of Larotrectinib in TRK Fusion-Positive Cancers in Adults and Children. N Engl J Med. 2018; 378(8): 731-9. https://doi.org/10.1056/NEJMoa1714448