Skip to Main Content

+

  • • History of irradiation to the neck (in some patients)

    • Painless or enlarging nodule, dysphagia or hoarseness

    • Firm or hard, fixed thyroid nodule; cervical lymphadenopathy

    • Family history of thyroid cancer

    • Appears later in life

    • Invasive, nonencapsulated tumor

    • Patients often die of local recurrence, pulmonary metastases, or both

    • Microscopically, has 3 different types:

    • 1. Giant cell

      2. Spindle cell

      3. Small cell

++

Epidemiology

+

  • • Occurs principally in women beyond middle life (peak incidence in the seventh decade of life)

    • 1% of all thyroid cancers

    • 50% have clinically positive cervical lymph nodes at presentation

    • 30% have distant metastases at presentation

++

Symptoms and Signs

+

  • • Hard, irregular anterior neck mass

    • Quickly enlarging mass

    • May be tender

    • Dyspnea or stridor

    • Dysphagia or odynophagia

+

  • • These tumors are reliably diagnosed by fine-needle aspiration biopsy

+

  • • History and physical exam

    • Fine-needle aspiration biopsy

+

  • • Complete surgical resection is the best chance for cure

    • Local recurrence after surgical treatment is the rule

    • Combination therapy with chemotherapy and external beam radiation offers the best palliation, but is rarely curative

++

Surgery

++

Indications

+

  • • All tumors should be excised as completely as possible

    • Tracheostomy below the tumor may be helpful for patients with actual or impending airway compromise

++

Contraindications

+

  • • Advanced metastatic disease

++

Medications

+

  • • Radioiodine ablation 6 weeks after surgery

    • Thyroid-stimulating hormone suppression with thyroid hormone (may have little effect since cells are undifferentiated)

++

Treatment Monitoring

+

  • • Monthly physical exam for local recurrence

++

Prognosis

+

  • • Almost all patients have recurrence and die of the disease

    • Life expectancy after diagnosis is typically about 6 months

    • 1-year survival is 5-15%

++

References

Kebebew E et al: Anaplastic thyroid carcinoma. Treatment outcome and prognostic factors. Cancer 2005;103:1330.  [PubMed: 15739211]

++

Practice Guidelines

+

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.