A Large Nonmetastatic Anaplastic Thyroid Cancer with Complete Thyroidal Confinement

Abstract

Anaplastic thyroid cancer (ATC) is rare but extremely aggressive, which accounts for about 2% of all thyroid cancers yet nearly 50% of thyroid-cancer-associated deaths in the United States. The median survival time from diagnosis is 5 months, with a 1-year survival rate of only 20%. We report here a case of ATC in a 56-year-old man who survived a large ATC. Preoperative fine-needle aspiration biopsy study to a large right thyroid mass suggested ATC. Total thyroidectomy with radical lateral neck and central neck dissection removed a well-circumscribed 9.5 cm tumor without extrathyroidal extension or lymphovascular invasion. All 73 lymph nodes removed were negative for metastasis. The tumor consisted of highly pleomorphic, undifferentiated cells with large zones of necrosis and loss of thyroid transcription factor-1 and thyroglobulin expression. A focal well-differentiated component and PAX8 expression confirmed its thyroid follicular cell origin. Nine months after postsurgical adjuvant concurrent radiation therapy and chemotherapy, the patient remained well without clinical, biochemical, and radiographical evidence for cancer recurrence. This is an unusual case of ATC in that it is one of the largest ATC tumors reported to display mild pathologic behavior and relatively long-term patient survival.

Association ofTERTPromoter Mutation 1,295,228 C>T WithBRAFV600E Mutation, Older Patient Age, and Distant Metastasis in Anaplastic Thyroid Cancer

“…The present study included a case of ATC patients who has been currently living well without ATC recurrence more than four years after surgical removal and radiation therapy of a 9-cm ATC tumor. We previously reported the pathological characteristics and clinical course of this unusual patient in a case report (26). The tumor in this patient was a histologically typical ATC but was well-circumscribed without extrathyroidal invasion and none of the 73 lymph nodes removed was positive for metastasis.…”

Anaplastic Thyroid Carcinoma: Current Issues in Genomics and Therapeutics

“…While various treatments have been tested and established, it has been difficult to achieve complete remission of anaplastic thyroid carcinoma. In the recent literature, 9 cases with complete remission within the observation period (at least over 9 months) of anaplastic thyroid carcinoma assessed by pathological examination and/or FDG-PET were reported in detail (Table 3) [146][147][148][149][150][151][152][153]. All the patients with complete remission were of stage IVB and underwent combined treatments of chemotherapy and radiotherapy.…”