Anaplastic carcinoma of the thyroid gland

Anaplastic carcinoma of the thyroid gland is the most serious malignant thyroid disease. Although only two percent of thyroid cancers are due to this kind of carcinoma, it is still responsible for about 40% of fatal cases of thyroid cancer. The aggressive caracter of this disorder makes it even more difficult to study.

 

Pathophysiology

Generally, the anaplastic thyroid carcinoma occurs to people living in iodine deficient areas and especially with a background of previous thyroid diseases (eg, a pre-existing goiter, follicular thyroid cancer, papillary thyroid cancer). Local damage can often occur to adjacent structures, such as the trachea or esophagus.

Anaplastic carcinoma has a rapid evolution and early dissemination. Most common in areas in which the carcinoma may expand include the lungs, bones and even brain. In 50% of cases, patients deal with lung metastases.

Frequency

In the United States Of America anaplastic carcinoma of the thyroid gland represents less than two percent of cases of malignant thyroid tumor. Fortunately, the incidence appears to decline. Internationally, the frequency is the same as in the U.S..

Mortality

This condition often progresses rapidly. The survival rate is approximately 10% and most people do not live more than a few months after diagnosis. This type of carcinoma affects three times more women than men, and in terms of age, the incidence is higher at 60-70 years old.

Differential Diagnosis

Anaplastic thyroid carcinoma can be diagnosed by laboratory blood tests or urine and it is necessary to find out the level of serial calcium in the body to exclude medullar thyroid carcinoma and parathyroid neoplasm. A chest radiography can confirm or infirm lung metastases.

Procedures:

Aspiration with a special needle usually gives enough information to allow diagnosis, although if this does not provide the desired results, the patient is required a surgery to remove tissue for biopsy. In general, the anaplastic thyroid carcinoma is a large fleshy tumor. The possible infiltration of adjacent structures can be observed using a microscope. The tumor may contain traces of spontaneous necrosis or hemorrhage. The main histological variants include giant cells, squamous cells, and others. Thyroid lymphoma is the only curable disease that could be mistaken for carcinoma. In this case it is necessary to test lymphoid tissue for markers.

Alternative Therapy

Although thyroid carcinoma is usually very resistant, local external radiotherapy is used to keep it under control. There is evidence that excessive fractionation of the carcinoma generates positive effects of healing, allowing a higher dose of radiation with less toxicity. Chemotherapy is another treatment option, although so far there isn’t a type of chemotherapy which can eliminate the lethal effect of the disease, although it may prolong the patient’s life.

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