Anaplastic Thyroid Carcinoma

Updated: Apr 16, 2015
  • Author: Anastasios K Konstantakos, MD; Chief Editor: Jules E Harris, MD, FACP, FRCPC  more...
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Overview

Background

Anaplastic carcinoma of the thyroid (ATC) is the most aggressive thyroid gland malignancy. Although ATC accounts for less than 2% of all thyroid cancers, it causes up to 40% of deaths from thyroid cancer. The aggressive nature of ATC makes treatment studies difficult to perform.

See the figure below.

Algorithm for the management of a solitary thyroid Algorithm for the management of a solitary thyroid nodule. FNAB = fine needle aspiration biopsy; US = ultrasonography.
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Pathophysiology

Anaplastic carcinoma of the thyroid (ATC) generally occurs in people in iodine-deficient areas and in a setting of previous thyroid pathology (eg, preexisting goiter, follicular thyroid cancer, papillary thyroid cancer). Local invasion of adjacent structures (eg, trachea, esophagus) commonly occurs.

ATC has a rapid course and early dissemination. The most common sites of distant spread include, in descending order, the lung, bone, and brain. Metastases, particularly in the lung, are likely to be present at diagnosis more than 50% of the time.

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Epidemiology

Frequency

United States

Anaplastic carcinoma of the thyroid (ATC) constitutes less than 2% of all thyroid malignancies. Fortunately, the incidence appears to be declining.

International

Worldwide frequency likely approximates that in the United States.

Mortality/Morbidity

Anaplastic carcinoma of the thyroid (ATC) typically has a rapidly progressive course. The overall 5-year survival rate is reportedly less than 10%, and most patients do not live longer than a few months after diagnosis. [1]

Sex

The female-to-male ratio is approximately 3:1.

Age

Peak incidence occurs during the sixth to seventh decades of life. The age range of affected patients reportedly is 15-90 years.

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