Endocrine Abstracts

Introduction: Anaplastic thyroid carcinoma also known as undifferentiated carcinoma is a rare and highly aggressive malignant tumor. It continues to rank as one of the deadliest diseases worldwide and carries a very poor prognosis. It is an aggressive locoregional disease with a high metastatic capacity. There is no agreement with regards to the best treatment.

Material and Methods: We reporteded 6 cases of anaplastic thyroid carcinomas treated in the ENT department of Tahar Sfar Hospital in Mahdia. Clinical manifestations and treatments were analysed during a period of 26 years (1996–2018).

Results: The median age was 65 ranging from 47 years to 78 years. Females were more affected, 5 cases occurred in women and one male. The common manifestation was neck enlargement which is associated to hoarseness in two cases. Duration before diagnosis ranged from 4 weeks to 20 weeks with an average of 14 weeks. ALL the cases had lymph node metastases, 4 cases had trachea invasion, 4 cases had subhyoid muscle invasion. One patient had bone metastasis. Histological findings were consistent with the diagnosis of anaplastic carcinoma. Histological examination was performed in total thyroidectomy specimens in 2 cases, and in a microbiopsy of the thyroid gland in 4 cases. A tracheostomy was performed for 3 cases. Four patients underwent total thyroidectomy and 2 patients had inoperable cancer. All patients received Radiation Therapy. All the patients died within the follow-up period of 11 months (ranged from 8 to 13 months).

Conclusion: Complete surgical resection is associated with better survival but is very difficult to achieve due to aggressive biological behaviour. Multimodal therapy is associated with better survival and a better quality of life. There is a need for more effective systemic treatments as extensive surgical resections have little overall benefit in highly invasive and metastatic disease.