Anaplastic thyroid cancer, which is from the family of undifferentiated cancers of the thyroid, constitutes 2-3% of thyroid cancers. It is a very aggressive type of cancer with a poor prognosis. It is one of the deadliest cancers worldwide. It metastasizes to tissues around the thyroid gland, regional and distant lymphatic tissues, and distant organs and tissues.
In anaplastic thyroid cancers, patients usually develop distant metastases when they are diagnosed. Anaplastic thyroid cancers are more common in areas where goiter is common. They are usually elderly patients. It is twice as common in women. About 20% of these patients already have pre-differentiated thyroid cancers.
Diagnosis of anaplastic thyroid cancer:
Anaplastic thyroid cancer tissue usually has a tissue larger than 6 cm, homogeneous, with necrotic and hemorrhagic areas, and invading surrounding tissues. Cell types can be spindle cell, giant cell or epithelial type.
Anaplastic thyroid cancers usually have fast-growing tissues. It is painful and hard. The complaint of a painful, hard and rapidly growing mass in the neck should always be evaluated in terms of anaplastic thyroid cancers. Hoarseness, difficulty in swallowing, respiratory distress and cough, which can be seen in all thyroid enlargements, can also be seen in these patients. Metastases to regional lymph nodes can be detected.
Thyroid ultrasonography reveals solid, mass-feeling, hypoechoic, irregular margin, calcification, and thyroid cancer tissue with cervical lymph node involvement.
Fine-needle aspiration biopsy may be done to support the diagnosis. Extraordinary atypical cells and mitotic tissues are evident in fine-needle aspiration biopsy. Necrosis and signs of inflammation may also be seen.
The definitive diagnosis of anplastic thyroid carcinoma can be made by biopsy or frozen section examination performed during the surgical operation.
Computed tomography or magnetic resonance imaging techniques can be used to determine the extent of anaplastic thyroid cancer.
Staging assessment with computed tomography scanning (FDG-PET/CT) combined with F-fluorodeoxyglucose positron emission tomography (FDG-PET) has diagnostic value in anaplastic thyroid carcinoma because of its high glucose uptake by cancerous tissues and enhanced expression of the glucose transporter (GLUT-1). is a finding.
Treatment of anaplastic thyroid cancer:
The treatment of anaplastic thyroid cancer is to relieve the patient surgically. Debulking surgery is the removal of tumor tissue around the trachea to protect the trachea. With this treatment, the patient can breathe more easily. Complete removal is almost impossible because the tumor has spread excessively.
Radiotherapy is used for tumors that are caught at an early stage, smaller in size, and tumors that have been completely cleared by surgery. However, it does not respond to radioactive iodine-131 treatment.
Anaplastic thyroid cancers must be well differentiated from other cancer types. Other cancers, lymphomas and sarcomas of the thyroid gland should also be analyzed carefully.
All anaplastic thyroid cancers are considered Stage 4 when diagnosed. Stage 4 means cancer that has spread beyond the thyroid tissue.
Anaplastic thyroid cancers are cancers with a poor prognosis. The 2-year survival rate is 12%. The majority of patients die within a year from airway obstruction or complications from lung metastases. Therefore, total thyroidectomy may prevent the development of anaplastic cancer in long-standing goitre diseases and other thyroid malignancies.