Long Term Survival in a Patient with Anaplastic Thyroid Carcinoma Treated with Cricotracheal Resection

Gregory Sayer, Douglas Sidell, Joel A. Sercarz

Division of Head and Neck Surgery, University of California, Los Angeles, USA.

DOI: 10.4236/ijohns.2012.12008                

Abstract

Anaplastic thyroid cancer is an uncommon malignancy with a poor prognosis. Elderly patients are most commonly afflicted and survival past 3 years occurs in less than 5% of patients. Management of these patients is challenging, and the importance of palliation, airway protection, and aggressive resection is debated. In this report, we describe a patient with anaplastic thyroid carcinoma who presented with respiratory distress due to invasion of the tracheal cartilage. The patient was managed with cricotracheal resection, total thyroidectomy and thyrotracheal anastomosis. The patient is currently disease free 3.5 years after resection and postoperative radiation therapy with interval neck dissection.

Keywords

Anaplastic; Thyroid Cancer; Survival; Treatment; Surgery

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	R. L. Neff, W. B. Farrar, R. T. Kloos and K. D. Burman, “Anaplastic Thyroid Cancer,” Endocrinology and Metabolism Clinics of North America, Vol. 37, No. 2, 2008, pp. 525-538. doi:10.1016/j.ecl.2008.02.003
[2]	C. Kosary, L. A. G. Ries, J. L. Young, G. E. Keel, et al., “SEER Survival Monograph: Cancer Survival Among Adults: U.S. Seer Program, 1988-2001, Patient and Tumor Characteristics,” Bethesda, National Cancer Institute, 2007.
[3]	E. Kebebew, F. S. Greenspan, O. H. Clark, K. A. Woeber and A. McMillan, “Anaplastic Thyroid Carcinoma. Treatment Outcome and Prognostic Factors,” Cancer, Vol. 103, No. 7, 2005, pp. 1330-1335. doi:10.1002/cncr.20936
[4]	E. Brignardello, M. Gallo, I. Baldi, et al., “Anaplastic Thyroid Carcinoma: Clinical Outcome of 30 Consecutive Patients Referred to a Single Institution in the Past 5 Years,” European Journal of Endocrinology, Vol. 156, No. 4, 2007, pp. 425-430. doi:10.1530/EJE-06-0677
[5]	R. K. Tan, R. K. Finley III, D. Driscoll, et al., “Anaplastic Carcinoma of the Thyroid: A 24-Year Experience,” Head & Neck, Vol. 17, No. 1, 1995, pp. 41-48. doi:10.1002/hed.2880170109
[6]	S. W. Wiseman, T. R. Loree, N. R. Rigual, et al., “Anaplastic Transformation of Thyroid Cancer: Review of Clinical, Pathologic, and Molecular Evidence Provides New Insights into Disease Biology and Future Therapy,” Head & Neck, Vol. 25, No. 8, 2003, pp. 662-670. doi:10.1002/hed.10277
[7]	W. R. Cornett, A. K. Sharma, T. A. Day, et al., “Anaplastic Thyroid Carcinoma: An Overview,” Current Oncology Reports, Vol. 9, No. 2, 2007, pp. 152-158. doi:10.1007/s11912-007-0014-3
[8]	O. Nilsson, J. Lindeberg, J. Zedenius, et al. “Anaplastic Giant Cell Carcinoma of the Thyroid Gland: Treatment and Survival over a 25-Year Period,” World Journal of Surgery, Vol. 22, No. 7, 1998, pp. 725-730. doi:10.1007/s002689900460
[9]	A. R. Shaha, “Airway Management in Anaplastic Thyroid Carcinoma,” The Laryngoscope, Vol. 118, 2008, pp. 11951198. doi:10.1097/MLG.0b013e3181726d36
[10]	Y. Kitamura, K. Shimizu and M. Nagahama, et al., “Immediate Causes of Death in Thyroid Carcinoma: Clinicopathological Analysis of 161 Fatal Cases,” Journal of Clinical Endocrinology and Metabolism, Vol. 84, No. 11, 1999, pp. 4043-4049. doi:10.1210/jc.84.11.4043
[11]	H. Chang, K. Nam, W. Y. Chung and C. S. Park, “Anaplastic Thyroid Carcinoma: A Therapeutic Dilemma,” Yonsei Medical Journal, Vol. 46, No. 6, 2005, pp. 759-764. doi:10.3349/ymj.2005.46.6.759
[12]	J. Pierie, A. Muzikansky, R. Gaz, W. Faquin and M. Ott, “The Effect of Surgery and Radiotherapy on Outcome of Anaplastic Thyroid Carcinoma,” Annals of Surgical Oncology, Vol. 9, No. 1, 2002, pp. 57-64. doi:10.1245/aso.2002.9.1.57
[13]	B. McIver, I. D. Hay, D. F. Giuffrida, et al., “Anaplastic Thyroid Carcinoma: A 50-Year Experience at a Single Institution,” Surgery, Vol. 130, No. 6, 2001, pp. 1028-1034. doi:10.1067/msy.2001.118266
[14]	M. Kihara, A. Miyauchi, A. Yamauchi and H. Yokomise, “Prognostic Factors of Anaplastic Thyroid Carcinoma,” Surgery Today, Vol. 34, No. 5, 2004, pp. 394-398. doi:10.1007/s00595-003-2737-6
[15]	C. Are and A. Shaha, “Anaplastic Thyroid Carcinoma: Biology, Pathogenesis, Prognostic Factors, and Treatment Approaches,” Annals of Surgical Oncology, Vol. 13, No. 4, 2006, pp. 453-464. doi:10.1245/ASO.2006.05.042
[16]	J. Chen, J. D. Tward, D. C. Shrieve and Y. J. Hitchcock, “Surgery and Radiotherapy Improves Survival in Patients with Anaplastic Thyroid Carcinoma: Analysis of the Surveillance, Epidemiology, and End Results 1983-2002,” American Journal of Clinical Oncology, Vol. 31, No. 5, 2008, pp. 460-464. doi:10.1097/COC.0b013e31816a61f3
[17]	P. I. Haigh, P. H. Ituarte, H. S. Wu, et al., “Completely Resected Anaplastic Thyroid Carcinoma Combined with Adjuvant Chemotherapy and Irradiation Is Associated with Prolonged Survival,” Cancer, Vol. 91, No. 12, 2001, pp. 2335-2342. doi:10.1002/1097-0142(20010615)91:12<2335::AID-CNCR1266>3.0.CO;2-1
[18]	A. T. Swaak-Kragten, J. H. de Wilt, P. I. Schmitz, M. Bontenbal and P. C. Levendag, “Multimodality Treatment for Anaplastic Thyroid Carcinoma-Treatment Outcome in 75 Patients,” Radiotherapy and Oncology, Vol. 92, No. 1, 2009, pp. 100-104. doi:10.1016/j.radonc.2009.02.016
[19]	E. M. ElBashier, A. B. H. Widtalla and M. E. Ahmed, “Tracheostomy with Thyroidectomy: Indications, Management and Outcome: A Prospective Study,” International Journal of Surgery, Vol. 6, No. 2, 2008, pp. 147-150. doi:10.1016/j.ijsu.2008.01.010
[20]	N. Besic, M. Hocevar, J. Zgajnar, et al., “Prognostic Factors in Anaplastic Carcinoma of the Thyroid—A Multivariate Survival Analysis of 188 Patients,” Langenbecks Archive of Surgery, Vol. 390, No. 3, 2005, pp. 203-208. doi:10.1007/s00423-004-0524-5
[21]	K. Sugino, K. Ito, T. Mimura, et al., “The Important Role of Operations in the Management of Anaplastic Thyroid Carcinoma,” Surgery, Vol. 131, No. 3, 2002, pp. 245-248. doi:10.1067/msy.2002.119936