Giant Anaplastic Thyroid Carcinoma of Sarcomatoid Type with Obstructive Symptoms: A Case Report
Gustavo D Saenz-Poma, Shirley N Cisneros-Chumacero, Juan D Millan-Landeo, Nayra Quispe-Yauri, Alba S Zevallos
Anaplastic thyroid carcinoma, Case report, Emergency thyroidectomy, Goiter
Citation Information :
Saenz-Poma GD, Cisneros-Chumacero SN, Millan-Landeo JD, Quispe-Yauri N, Zevallos AS. Giant Anaplastic Thyroid Carcinoma of Sarcomatoid Type with Obstructive Symptoms: A Case Report. World J Endoc Surg 2023; 15 (1):18-22.
Aim: To report the surgical approach of a giant thyroid tumor despite the histological type.
Background: Although salt for human consumption contains iodine; in some populations far from civilization stone salt (noniodized salt) is still used, the latter plus a lack of medical attention, leads to the development of goiter with excessive growth and possible malignant transformation.
Case description: We report the case of surgical treatment of a giant tumor of the thyroid gland in a 55-year-old female patient who was admitted to the emergency department with respiratory distress and difficulty swallowing food. She underwent an emergency total thyroidectomy due to airway obstruction. During the surgical treatment, adhesions of the tumor to the cervical esophagus and to the aorta artery in its projection towards the mediastinal region were found.
Conclusion: Anaplastic thyroid carcinoma is the rarest and most dangerous of all types of thyroid cancers, so extreme caution should be exercised in the treatment choice according to the patient's case.
Clinical significance: Although the literature establishes the management of sarcomatoid anaplastic thyroid tumors, surgery remains the first option in severe cases with obstructive symptoms.
Le QV, Nguyen HV, Mai NTK, et al. Surgical treatment result of giant thyroid tumor: case series in Vietnam. Int J Surg Case Rep 2019;54:103–107. DOI: 10.1016/j.ijscr.2018.11.047
Shah J, Patel S, Singh B, et al. Jatin Shah's head and neck surgery and oncology. 5ta ed. Philadelphia: Elsevier; 2019.
Bible KC, Kebebew E, Brierley J, et al. 2021 American Thyroid Association Guidelines for management of patients with anaplastic thyroid cancer. Thyroid 2021;31(3):337–386. DOI: 10.1089/thy.2020.0944
Rao SN, Smallridge RC. Anaplastic thyroid cancer: an update. Best Pract Res Clin Endocrinol Metab 2023;37(1):101678. DOI: 10.1016/j.beem.2022.101678
Gazeu A, Lopez J, Guyetant S, et al. Poorly differentiated thyroid carcinoma with pleomorphic giant cells-a case report. Virchows Arch 2020;477(4):597–601. DOI: 10.1007/s00428-020-02807-7
Volante M, Lam AK, Papotti M, et al. Molecular pathology of poorly differentiated and anaplastic thyroid cancer: what do pathologists need to know? Endocr Pathol 2021;32(1):63–76. DOI: 10.1007/s12022-021-09665-2
Bai Y, Kakudo K, Jung CK. Updates in the pathologic classification of thyroid neoplasms: a review of the world health organization classification. Endocrinol Metab (Seoul) 2020;35(4):696–715. DOI: 10.3803/EnM.2020.807
Abe I, Lam AK. Anaplastic thyroid carcinoma: updates on WHO classification, clinicopathological features and staging. Histol Histopathol 2021;36(3):239–248. DOI: 10.14670/HH-18-277
Greenberg JA, Moore MD, Thiesmeyer JW, et al. Coexisting papillary and anaplastic thyroid cancer: elucidating the spectrum of aggressive behavior. Ann Surg Oncol 2023;30(1):137–145. DOI: 10.1245/s10434-022-12553-6
Khairy G. Anaplastic transformation of differentiated thyroid carcinoma. Int J Health Sci (Qassim) 2009;3(1):93–96. PMID:21475516.
Amaral M, Afonso RA, Gaspar MM, et al. Anaplastic thyroid cancer: how far can we go? EXCLI J 2020;19:800–812. DOI: 10.17179/excli2020-1302
Jannin A, Escande A, Al Ghuzlan A, et al. Anaplastic thyroid carcinoma: an update. Cancers (Basel) 2022;14(4):1061. DOI: 10.3390/cancers14041061
Guan L, Zhao X, Tang L, et al. Thyroid transcription factor-1: structure, expression, function and its relationship with disease. Biomed Res Int 2021;2021:9957209. DOI: 10.1155/2021/9957209
Cantos Sánchez de Ibargüen B, Sánchez Ruiz A, Maximiano Alonso C, et al. Carcinoma de origen desconocido: diagnóstico y manejo terapéutico. Oncología (Barcelona) 2006;29(3):11–22. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0378-48352006000300002&lng=es&nrm=iso
Shelly D, Gupta D, Mishra S, et al. Osteoclastic variant of anaplastic thyroid carcinoma: a case report of rare entity. J Cancer Res Ther 2019;15(3):704–707. DOI: 10.4103/jcrt.JCRT_355_16
Stenman A, Hellgren LS, Jatta K, et al. Metastatic anaplastic thyroid carcinoma in complete remission: morphological, molecular, and clinical work-up of a rare case. Endocr Pathol 2020;31(1):77–83. DOI: 10.1007/s12022-020-09606-5
Perrier ND, Brierley JD, Tuttle RM. Differentiated and anaplastic thyroid carcinoma: Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin 2018;68(1):55–63. DOI: 10.3322/caac.21439
Hatch-McChesney A, Lieberman HR. Iodine and iodine deficiency: a comprehensive review of a re-emerging issue. Nutrients 2022;14(17):3474. DOI: 10.3390/nu14173474
Pearce EN, Lazarus JH, Moreno-Reyes R, et al. Consequences of iodine deficiency and excess in pregnant women: an overview of current knowns and unknowns. Am J Clin Nutr 2016;104(suppl_3):918S–923S. DOI: 10.3945/ajcn.115.110429
Moreno F, Reyes C, Pineda CA, et al. Anaplastic thyroid carcinoma with unusual long-term survival: a case report. J Med Case Rep 2022;16(1):39. DOI: 10.1186/s13256-021-03249-8
Salehian B, Liem SY, Mojazi Amiri H, et al. Clinical trials in management of anaplastic thyroid carcinoma; progressions and set backs: a systematic review. Int J Endocrinol Metab 2019;17 (1):e67759. DOI: 10.5812/ijem.67759