Thyroid Awareness Month – Poorly Differentiated Thyroid Cancer (PDTC)

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Poorly differentiated thyroid cancer (PDTC) is an uncommon but important subtype that sits between differentiated thyroid cancer (papillary/follicular) and anaplastic thyroid cancer in terms of aggressiveness.


    🧠 What defines PDTC?
    Tumors show loss of typical thyroid differentiation
    Often described with insular, trabecular, or solid growth patterns
    More aggressive than papillary or follicular cancer
    Less responsive to radioactive iodine than well-differentiated cancers


    🔍 How is PDTC diagnosed?
    Definitive diagnosis is made on surgical pathology
    Based on specific histologic criteria (e.g., high mitotic rate, necrosis, insular pattern)
    FNA may suggest aggressive disease but is not always definitive


    ⚖️ How is PDTC treated?


    Management requires multidisciplinary, risk-adapted care:
    Total thyroidectomy is usually recommended
    Therapeutic lymph node dissection when nodal disease is present
    Radioactive iodine may be considered, but effectiveness is variable
    External beam radiation and systemic therapy in selected cases
    Close, long-term surveillance


    📈 Prognosis
    Worse than papillary or follicular thyroid cancer
    Better than anaplastic thyroid cancer
    Outcomes depend on:
    Tumor stage
    Completeness of surgical resection
    Presence of distant metastases


    🦋 Early recognition and expert pathology review are critical for optimal outcomes.

    👨‍⚕️ Dr. Rodrigo Arrangoiz, MD
    Surgical Oncologist – Thyroid, Head & Neck, Breast
    Mount Sinai Medical Center


    📌 Take-home message:
    Poorly differentiated thyroid cancer is uncommon but serious—timely diagnosis and comprehensive care matter.


    📚 References
    Lloyd RV et al. WHO Classification of Tumours of Endocrine Organs
    Haugen BR et al. ATA Guidelines for Differentiated Thyroid Cancer. Thyroid
    Volante M et al. Poorly differentiated thyroid carcinoma. Endocr Relat Cancer
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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