Anaplastic Thyroid Cancer |
| Anaplastic
or undifferentiated thyroid cancer occurs very rarely during young
adults and children. Most cases of thyroid malignancy are well
differentiated papillary and follicular variants. Other times medullary
thyroid carcinoma associated with multiple endocrine neoplasia
syndromes. Nevertheless it's good to learn what is the characteristic
of this unusual disease in young adults and children.
Poorly-differentiated thyroid carcinoma is a stage in the development
of anaplastic carcinoma from well-differentiated neoplastic
transformation of follicular epithelium. The BRAFT1799A mutation has
been identified. In patients under 40 years of age, encapsulated
poorly-differentiated tumors are more frequent with a trabecular
histological pattern alone with a much smaller size (30 mm). Pathologic
criteria used in the diagnosis of poorly or undifferentiated thyroid
carcinoma includes (1) presence of a solid/trabecular/insular pattern
of growth, (2) absence of the conventional nuclear features of
papillary carcinoma, and (3) presence of at least one of the following
features: convoluted nuclei; mitotic activity >or =3 x 10 HPF; and
tumor necrosis. Among papillary carcinomas, the frequency of a solid
growth pattern, a criterion for classifying a tumor as poorly
differentiated, was higher in the Belarus region of Russia than that in
Japan. Management of anaplastic thyroid malignancy is total
thyroidectomy, since chemotherapy, radiotherapy and radioiodine are of
no avail. References: 1- Datta C, Bhattacharyya S, Ghosh A, Ghosh S: Dedifferentiated papillary carcinoma of thyroid in an adolescent girl--a case report. Indian J Pathol Microbiol. 48(4):496-7, 2005 2- Volante M, Collini P, Nikiforov YE, Sakamoto A, Kakudo K, Katoh R, Lloyd RV, LiVolsi VA, Papotti M, Sobrinho-Simoes M, Bussolati G, Rosai J: Poorly differentiated thyroid carcinoma: the Turin proposal for the use of uniform diagnostic criteria and an algorithmic diagnostic approach. Am J Surg Pathol. 31(8):1256-64, 2007 3- Shirahige Y, Ito M, Ashizawa K, Motomura T, Yokoyama N, Namba H, Fukata S, Yokozawa T, Ishikawa N, Mimura T, Yamashita S, Sekine I, Kuma K, Ito K, Nagataki S: Childhood thyroid cancer: comparison of Japan and Belarus. Endocr J. 45(2):203-9, 1998 4- Kumagai A, Namba H, Mitsutake N, Saenko VA, Ohtsuru A, Ito M, Noh JY, Sugino K, Ito K, Yamashita S: Childhood thyroid carcinoma with BRAFT1799A mutation shows unique pathological features of poor differentiation. Oncol Rep. 16(1):123-6, 2006 5- Gétaz EP, Shimaoka K, Rao U: Anaplastic carcinoma of the thyroid following external irradiation. Cancer. 43(6):2248-53, 1979 |
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