Anaplastic Thyroid Carcinoma: A 20-year Institutional Review

Abstract

Background: Anaplastic thyroid cancers (ATC) are highly aggressive and lethal. Despite their low incidence, they account for a significant portion of thyroid cancer-related deaths. In this review, we will examine the clinical characteristics of ATC patients at our center over the past 20 years and their prognosis. Materials and methods: We retrospectively reviewed all ATCs diagnosed at Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia, from 2004 to 2023. Patients were identified from our lab database, and their clinical details were obtained from their medical records. Results: There were 42 patients, with a female-to-male ratio of 1.6:1 and a median age of 62 years. The majority (92.6%) presented with goiter larger than 4 cm and were female (61.9%). Only one patient had a history of differentiated thyroid cancer (DTC). Most patients (76.2%) presented with goiters lasting <10 years, while only 10 patients had a history lasting for >10 years. Hyperthyroidism was observed in only nine cases, while the rest were euthyroid. Common presenting complaints included dysphagia (59.5%), dyspnea (59.5%), and hoarseness of voice (57%). A large portion of the patients presented with advanced disease, with 26 patients showing distant metastasis, 28 patients exhibiting extrathyroidal extension, and 23 patients having lymph node involvement. The majority (66.7%) survive <3 months from the time of diagnosis. Conclusion: The management of ATC has evolved from palliative care to personalized therapies. However, the prognosis still remains grim. Further research and clinical trials are needed to optimize treatment strategies to improve quality of life and overall survival (OS).