Anaplastic thyroid carcinoma

Anaplastic thyroid carcinoma (ATC) is a highly aggressive form of thyroid cancer and accounts for ~1-2% of primary thyroid malignancies. Of all the subtypes, this carries the worst prognosis.


Typically occurs in the elderly (peak incidence in 6th to 7th decades). A significant proportion of patients may have a history of concurrent multinodular goitre. There is recognised female predilection 6.

Clinical presentation

Patients tend to present late. Compressive symptoms of neighouring structures can be common.

Radiographic features


May show microcalcification 3. Usually seen as a infiltrative lesion.


Useful for assessment of tumour invasion 1 as well as metastatic burden. Lymph node +/- metastatic involvement is generally common at time of CT assessment 5. Typically seen as a highly infiltrative lesion about the thyroid gland

Nuclear imaging
  • radioiodine: usually has no uptake 4.

Treatment and prognosis

Carries a very poor prognosis with 5 year survival ≈5%. Considered invariably fatal 6.

Differential diagnosis

Consider other infiltrative thyroid neoplasms, such as:

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