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Anaplastic thyroid cancer

Definition

Anaplastic thyroid carcinoma is a rare and aggressive form of cancer of the thyroid gland.

Alternative Names

Anaplastic carcinoma of the thyroid

Causes, incidence, and risk factors

Anaplastic thyroid cancer grows very rapidly and is an invasive type of thyroid cancer. It occurs most often in people over age 60. The cause is unknown.

Anaplastic cancer accounts for only about 1% of all thyroid cancers.

Symptoms

  • Cough
  • Coughing up blood
  • Difficulty swallowing
  • Hoarseness or changing voice
  • Loud breathing
  • Lower neck mass, often noted to be rapidly enlarging

Signs and tests

A physical examination almost always show a neck mass.

  • A CT scan or MRI of the neck may show a tumor growing from the thyroid gland.
  • A thyroid biopsy shows anaplastic cancer.
  • An examination of the airway with a fiberoptic scope (laryngoscopy) may show a paralyzed vocal cord.
  • A thyroid scan shows this mass to be "cold," meaning it does not absorb a radioactive isotope.

Thyroid function blood tests are usually normal.

Treatment

This type of cancer cannot be cured by surgery. For most patients, complete removal of the thyroid gland does not prolong their life.

Of other treatment options, only radiation therapy combined with chemotherapy give significant benefit.

Surgery to place a tube in the throat to help with breathing (tracheostomy) or in the stomach to help with eating (gastrostomy) may be needed.

For some patients, enrolling in a clinical trial of new thyroid cancer treatments may be an option.

Support Groups

The stress of illness can often be eased by joining a support group of people sharing common experiences and problems. See: Cancer - support group

Expectations (prognosis)

The prognosis of this disease is poor. Most people do not survive longer than 6 months due to the aggressive nature of this disease and lack of effective treatment options.

Complications

  • Spread of tumor within the neck
  • Metastasis (spread) of cancer to other body tissues or organs

Calling your health care provider

Call your health care provider if there is a persistent lump or mass in the neck, hoarseness, changing voice, cough, or coughing up blood.

References

Ladenson P, Kim M. Thyroid. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 244.

National Comprehensive Cancer Network. NCCN Guidelines in Oncology 2010: Thyroid Cancer. Version 1.2010.


Review Date: 3/2/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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