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.
Patients tend to present late. Compressive symptoms of neighouring structures can be common.
May show microcalcification 3. Usually seen as an 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
- radioiodine: usually has no uptake 4.
Treatment and prognosis
Carries a very poor prognosis with 5 year survival ≈5%. Considered invariably fatal 6.
Consider other infiltrative thyroid neoplasms, such as:
- thyroid inflammatory disease
- thyroid neoplasms
- thyroid nodules
Ultrasound - neck and thyroid
- ultrasound (introduction)
neck and thyroid ultrasound
- Graves disease
- Hashimoto thyroiditis
- multinodular goitre
- thyroid nodules
- fine needle aspiration (FNA)
- postoperative assessment after thyroid cancer surgery
- lymph node levels of the neck
- parathyroid glands
- thyroid gland
- 1. Takashima S, Morimoto S, Ikezoe J et-al. CT evaluation of anaplastic thyroid carcinoma. AJR Am J Roentgenol. 1990;154 (5): 1079-85. AJR Am J Roentgenol (abstract) [pubmed citation]
- 2. Giuffrida D, Gharib H. Anaplastic thyroid carcinoma: current diagnosis and treatment. Ann. Oncol. 2000;11 (9): 1083-9. Ann. Oncol. (abstract) [pubmed citation]
- 3. Hoang JK, Lee WK, Lee M et-al. US Features of thyroid malignancy: pearls and pitfalls. Radiographics. 27 (3): 847-60. doi:10.1148/rg.273065038 [pubmed citation]
- 4. Silverman PM, Newman GE, Korobkin M et-al. Computed tomography in the evaluation of thyroid disease. AJR Am J Roentgenol. 1984;142 (5): 897-902. AJR Am J Roentgenol (abstract) [pubmed citation]
- 5. Rühli FJ, Hilfiker PR. Metastasis of thyroid cancer to the heart. AJR Am J Roentgenol. 2001;177 (2): 474. AJR Am J Roentgenol (full text) [pubmed citation]
- 6. Chiacchio S, Lorenzoni A, Boni G et-al. Anaplastic thyroid cancer: prevalence, diagnosis and treatment. Minerva Endocrinol. 2008;33 (4): 341-57. [pubmed citation]