[Anaplastic spindle and giant cell carcinoma of the thyroid (author's transl)]

77 cases of spindle and giant cell carcinoma of the thyroid were reviewed. This rapidly fata neoplasm extended beyond the capsule of the thyroid gland in all cases but one, with infiltration of the trachea or oesophagus in 3/4 of these cases at the time of diagnosis. 60% of the patients had lymph node metastases and 26% distant metastases. Due to the advanced stage of the primary tumour at the time of presentation, total resection was feasible in 13% of cases only. The prognosis is very poor; all patients died within 18 months. Correlations were demonstrated between lymph node metastases, distant metastases, tumour infiltration of trachea or oesophagus and shorter survival times. The survival time is prolonged in patients with partial tumour resection by adjuvant radiotherapy. 28% of all thyroid carcinomas seen at the 1st Department of Surgery of the University Hospital in Vienna between 1965 and 1976 were anaplastic. The high incidence in Austria is caused, in our opinion, by the higher rate of anaplastic transformation of long-standing, differentiated carcinomas in adenomatous goitres, which remain undetected clinically for years in this endemic goitre region because of their slow rate of growth.