Anaplastic thyroid carcinoma. A study of 70 cases

Area of Science:

• Endocrinology
• Oncology
• Pathology

Background:

• Anaplastic thyroid carcinoma (ATC) is a rare but aggressive thyroid malignancy.
• Understanding its diverse morphology and diagnostic markers is crucial for patient outcomes.

Purpose of the Study:

• To analyze the clinicopathologic features of 70 anaplastic thyroid carcinoma cases.
• To evaluate diagnostic markers and confirm the aggressive behavior of ATC.

Main Methods:

• Morphological analysis of tumor patterns (spindle, giant cell, squamoid).
• Ultrastructural examination for epithelial differentiation.
• Immunohistochemical staining for cytokeratin and carcinoembryonic antigen (CEA).

Main Results:

• Identified three main morphologic patterns: spindle, giant cell, and squamoid.
• Cytokeratin staining was the most useful diagnostic adjunct.
• Unexpected CEA positivity in squamoid tumors; thyroglobulin/calcitonin positivity was not confirmed.
• One-third of tumors showed association with better-differentiated components, suggesting dedifferentiation.
• All patients with follow-up data died of their tumor, confirming aggressive behavior.

Conclusions:

• Anaplastic thyroid carcinomas exhibit diverse morphology and aggressive behavior.
• Cytokeratin immunohistochemistry is valuable for diagnosis.
• Small cell tumors are distinct entities and should not be classified as ATC.