anaplastic thyroid carcinoma
Anaplastic thyroid carcinoma is a highly aggressive form of thyroid cancer and accounts for ~1-2% of primary thyroid malignancies. Of all the subtypes, this carries the worst prognosis.
Epidemiology
Typically occurs in the elderly with the peak incidence in the 6 and 7decades. A significant proportion of patients may have a history of concurrent multinodular goiter. There is a recognized female predilection .
Clinical presentation
Patients tend to present late. Compressive symptoms of neighboring structures are common.
Radiographic features
Ultrasound
May show microcalcification . Usually seen as an infiltrative lesion.
CT
CT is useful for assessment of extrathyroidal tumor invasion as well as regional lymph node and distant metastatic involvement, which are commonly found at the time of CT assessment .
The primary tumor typically appears as a highly infiltrative mass about the thyroid gland.
Nuclear imaging
- radioiodine: usually has no uptake .
Treatment and prognosis
The prognosis is very poor, with 5-year survival ~5% and considered invariably fatal . These tumors are automatically considered stage IV disease by the TNM staging system.
Differential diagnosis
Consider other infiltrative thyroid neoplasms, such as:
- thyroid lymphoma
- sarcoma of thyroid
See also
Siehe auch:
- Schilddrüsenkarzinom
- papilläres Schilddrüsenkarzinom
- Medulläres Schilddrüsenkarzinom
- ACR TI-RADS scoring system
- follikuläres Schilddrüsenkarzinom
- assessment of thyroid lesions
- Riedel-Thyreoiditis