Endocrine Abstracts

Introduction: Anaplastic thyroid carcinoma (ATC) is rare. This highly aggressive malignant tumor accounts for 2 – 3 % of all thyroid gland neoplasms. ATC continues to be one of the deadliest diseases worldwide and carries a very poor prognosis. The aim of this study was to describe the treatment modalities of ATC and its prognostic features.

Methods: A retrospective study of patients with ATC treated in our department between 2004 and 2021.

Results: Nine patients were included: 4 men and 5 women. The median age was 65 years [44 years – 90 years]. All patients presented with an anterior neck mass lasting for a median duration of 2.5 months [0.5 – 9] with a recent rapid increase in size. Weight loss and compressive symptoms were reported in all cases. Physical examination showed a hard anterior neck mass in all cases, with a median size of 7.8 cm [3 – 15]. Lateral neck lymph nodes were reported in 3 cases. Vocal fold paralysis was found in 4 patients. CT scan, performed in 8 cases, revealed a thyroid lesion pushing the trachea, the esophagus internal jugular vein, and carotid in 7 cases. Fine needle aspiration was performed in 3 patients and revealed a poorly differentiated thyroid carcinoma. Six patients underwent a total thyroidectomy. Central neck dissection was performed in 3 patients and lateral neck dissection in one patient. The diagnosis was made after thyroid biopsy in 2 patients and lymph node biopsy in 1 patient. The tumor invaded the trachea (n= 7), thyroid cartilage (n=1), cricoid cartilage (n= 1) esophagus (n= 1), recurrent laryngeal nerve (n= 3), internal jugular vein (n= 1). Three patients had pulmonary metastasis. Two patients had postoperative radiotherapy. Two patients had postoperative radio-chemotherapy. Recurrence was noted in these 4 cases. Palliative radio-chemotherapy was indicated in 1 case. The median survival duration was 4 months [2 days-13 months].

Conclusion: Anaplastic thyroid cancer is a devastating thyroid cancer with the poorest prognosis. As in our study, with conventional treatment including surgery, radiotherapy, and conventional chemotherapy the overall survival of patients with anaplastic thyroid cancer has been less than 12 months.