Rodrigues, Elisabete1,2,3; Saavedra, Ana1,2,3; Matos Lima, Luís4; Carvalho, Davide1,2,3
1 Department of Endocrinology, Diabetes and Metabolism of Centro Hospitalar de São João, Porto, Portugal
2 Faculty of Medicine, University of Porto, Porto, Portugal
3 Instituto de Investigação e Inovação em Saúde, Porto, Portugal
4 Department of Surgery of Centro Hospitalar de S. João, Porto, Portugal
Introduction: Poorly differentiated (PDTC) and anaplastic (ATC) are rare variants of thyroid carcinoma, associated with poor prognosis.
Objective: To describe the clinicopathological features of patients with PDTC or ATC treated at a tertiary hospital.
Methods: Retrospective study of patients with diagnosis of PDTC or ATC treated in our institution between 1996 and 2014.
Results: Twenty patients were included: 11 ATC (median age 68y, 55% male), 9 PDTC (median age: 67y, 88% female). Diagnosis – ATC: 5 patients by cytology, 2 by histology, 4 with both cytology/histology (1 concordant, 3 discordant); PDTC: 1 patient by cytology and the other 8 was established by histology. Neck mass, hoarseness and dysphagia were frequent symptoms. One PDTC patient presented with distant metastasis and other 3 were incidentally found (2 on image exams; 1 on histology). In ATC group, 5 patients had stage IVb disease and 6 stage IVc. In PDTC group, 2 patients had stage II, 3 stage III; 2 stage IVa and 2 stage IVc. Five patients in ATC group underwent total thyroidectomy, 2 radiotherapy/chemotherapy and the remaining died before any therapy. All but 1 patient with PDTC underwent surgery, 4 performed 131Iodine-treatment and 3 radiotherapy/chemotherapy. All patients in ATC group and 6 of PDTC group died because of thyroid carcinoma. 3 PDTC patients maintain follow-up (median of 84 months), 2 of them with persistent disease.
Discussion: Our single centre series, in accordance with published literature, shows the marked lethality of ATC and an intermediate position of PDTC in terms of biological aggressiveness.