Anaplastic Carcinoma of the Thyroid Gland

Irving B. Rosen, MD ■ Sylvia L. Asa, MD, PhD ■ James D. Brierley, BSc, MB

It is ironic that the thyroid gland harbors two polar variants of cancer in regard to aggressiveness in behavior. At the one pole is the common, unaggressive, infrequently lethal, well-differentiated carcinoma, usually papillary, sometimes follicular, which makes up 80% of all thyroid cancers. At the other pole is anaplastic thyroid cancer (ATC), which is invariably lethal and has until recently constituted 4% to 18% of thyroid cancer. Currently, ATC is showing a marked decline throughout the world, but in the United States it still constitutes 1.6% of thyroid cancers and accounts for more than half of the deaths from thyroid cancer. The survival of ATC cases is usually measured in months. Although there is a paucity of cases, leading institutions throughout the world nevertheless have reported their results of treatment in up to 160 patients, usually after several decades of experience. Authors agree that ATC is an infrequent cancer that is highly lethal and is usually unresponsive to currently available treatment such as surgery, radiation, and chemotherapy. New treatments are therefore necessary and are being developed in the hope that they will lead to improved survival in ATC patients.114

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