Anaplastic Thyroid Cancer

  • Anaplastic carcinoma of the thyroid (ATC):
    • Is the most aggressive thyroid gland malignancy
  • Although ATC accounts for less than 2% of all thyroid cancers:
    • It causes up to 40% of deaths from thyroid cancer
  • The aggressive nature of ATC:
    • Makes treatment studies difficult to perform
  • The overall 5-year survival rate:
    • Is reportedly less than 10%, and most patients do not live longer than a few months after diagnosis
  • Patients with ATC:
    • Typically present with a rapidly growing neck mass
  • Metastases, particularly in the lung:
    • Are likely to be present at diagnosis more than 50% of the time
  • Treatment is mostly palliative
  • Surgical resection with adjuvant radiation therapy and chemotherapy:
    • May prolong survival somewhat and improve quality of life
  • Anaplastic carcinoma of the thyroid (ATC):
    • Generally occurs in people in iodine-deficient areas and in a setting of previous thyroid pathology (eg, preexisting goiter, follicular thyroid cancer, papillary thyroid cancer)
  • Local invasion of adjacent structures (eg, trachea, esophagus):
    • Commonly occurs
  • ATC is believed to occur from a:
    • Terminal dedifferentiation of previously undetected long-standing thyroid carcinoma (eg, papillary, follicular)
  • ATC has a genetic association with:
    • Oncogenes C-myc, H-ras, and Nm23
  • Mutations in genes that code for BRAF, RAS, catenin (cadherin-associated protein), beta 1, PIK3CA, TP53, AXIN1, PTEN, and APC:
    • Have been found in ATC, and chromosomal abnormalities are common 
  • Jonker and collegues performed functional genomic RNA profiling on 25 anaplastic thyroid carcinoma and 80 normal thyroid samples and identified 301 significantly upregulated genes, of which the following were seen as potential therapeutic targets:
    • MTOR
    • MET 
    • WEE1
    • PSMD1
    • MERTK
    • FGFR3
    • RARG
    • ESR2
  • Anaplastic carcinoma of the thyroid (ATC):
    • Constitutes less than 2% of all thyroid malignancies in the United States:
      • Which equates to slightly more than 1000 new cases annually
    • Fortunately, the incidence appears to be declining
    • Worldwide frequency likely approximates that in the United States
  • The female-to-male ratio:
    • Is approximately 3:1
  • Peak incidence occurs during the sixth to seventh decades of life
  • The age range of affected patients reportedly is 15-90 years

#Arrangoiz #ThyroidSurgeon #CancerSurgeon #SurgicalOncologist #HeadandNeckSurgeon #EndocrineSurgery #ThyroidCancer #Miami #Mexico #MountSinaiMedicalCenter #Surgeon #Teacher #ThyroidNodules #RadioactiveIodine #RAI #PTC #MSMC

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