; 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
Poorly differentiated (PDTC) and anaplastic (ATC) are rare variants of thyroid carcinoma, associated with poor prognosis.
To describe the clinicopathological features of patients with PDTC or ATC treated at a tertiary hospital.
Retrospective study of patients with diagnosis of PDTC or ATC treated in our institution between 1996 and 2014.
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.
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.