Anaplastic carcinoma of the thyroid: A clinicopathologic study of 121 cases

TLDR

Anaplastic carcinoma of the thyroid is a rapidly growing neoplasm with a dismal prognosis. The study aims to evaluate the role of multimodality therapy in this disease. The authors reviewed 121 cases of anaplastic thyroid carcinoma treated at MD Anderson Cancer Center, Houston. The cohort had a mean survival of 7.2 ± 10 months, 35 % had foci of well‑differentiated carcinoma, immunostaining showed keratin in 84 %, vimentin in 93 %, and EMA in 33 %, younger age and earlier stage were associated with longer survival, and radical surgery alone did not improve outcomes.

Abstract

One hundred twenty-one cases of anaplastic carcinoma of the thyroid treated at M. D. Anderson Cancer Center, Houston, were reviewed. Anaplastic carcinoma is a rapidly growing neoplasm with a dismal prognosis. The mean survival of our patients was 7.2 ± 10 months. A significant percentage of our patients (35%) had areas of well-differentiated thyroid carcinoma elsewhere, supporting the hypothesis that anaplastic thyroid carcinoma arises from preexisting well-differentiated thyroid carcinoma. Twenty-four of 30 tumors analyzed (84%) stained for keratin, 28 (93.3%) stained for vimentin, and ten (33%) stained for epithelial membrane antigen. Younger patients lived longer than older patients, and patients whose disease was earlier-stage at presentation responded better than patients with metastases at presentation. Radical surgery alone did not significantly increase survival duration over less radical surgery. The role of multimodality therapy needs further evaluation.