Skip to main content
SpringerLink
Log in

Histopathologic Features and Clinical Outcome of Anaplastic Thyroid Carcinoma with a Minor Anaplastic Component

  • Published:
Endocrine Pathology Aims and scope Submit manuscript

Abstract

Although prior studies have reported that patients with anaplastic thyroid carcinoma (ATC) with a focal anaplastic component may have a prolonged survival compared to other ATC patients, the outcome data are limited. We evaluated a cohort of ATC resected between 2003 and 2018. Tumor slides were reviewed to confirm the diagnosis and to identify cases with a minor ATC component (defined as comprising < 10% of the tumor). We evaluated the clinical outcome of these patients compared to that of all other cohort patients (characterized as having conventional ATC). Our cohort was composed of 24 cases of ATC that underwent resection, including 8 (33%) with a minor ATC component. Tumors with a minor ATC component were predominantly associated with papillary thyroid carcinoma. For patients with tumors with a minor ATC component, the 1-year and 2-year survival rates and median survival for patients who died of disease were 88%, 43%, and 17 months (range 6–73 months), respectively. In comparison, for patients with conventional ATC, the 1-year and 2-year survival rates and median survival for patients who died of disease were 56%, 44%, and 7 months (range 2–26 months), respectively. There was no difference in 1- and 2-year survival or overall survival by Kaplan-Meier analysis for patients with tumors with a minor ATC component and those with conventional ATC. In conclusion, the difference in overall survival between ATC groups in our cohort was not significant; however, this could be due to the small cohort size or due to characteristics of our group with a minor ATC component; that is, no tumors in this group were limited to the thyroid (stage IVA), resectability with negative margins was infrequent, and 38% of this group had distant metastases at diagnosis (stage IVC).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Lim H, Devesa SS, Sosa JA, Check D, Kitahara CM Trends in thyroid cancer incidence and mortality in the United States, 1974-2013. JAMA 317: 1338-1348, 2017.

    Article  Google Scholar 

  2. Mao Y, Xing M Recent incidences and differential trends of thyroid cancer in the USA. Endocr Relat Cancer 23: 313-322, 2016.

    Article  CAS  Google Scholar 

  3. Chen J, Tward JD, Shrieve DC, Hitchcock YJ Surgery and radiotherapy improves survival in patients with anaplastic thyroid carcinoma: analysis of the surveillance, epidemiology, and end results 1983-2002. Am J Clin Oncol 31: 460-464, 2008.

    Article  CAS  Google Scholar 

  4. Glaser SM, Mandish SF, Gill BS, Balasubramani GK, Clump DA, Beriwal S Anaplastic thyroid cancer: prognostic factors, patterns of care, and overall survival. Head Neck 38 Suppl 1: E2083-2090, 2016.

    Article  Google Scholar 

  5. Kebebew E, Greenspan FS, Clark OH, Woeber KA, McMillan A Anaplastic thyroid carcinoma. Treatment outcome and prognostic factors. Cancer 103: 1330-1335, 2005.

    Article  Google Scholar 

  6. McIver B, Hay ID, Giuffrida DF et al. Anaplastic thyroid carcinoma: a 50-year experience at a single institution. Surgery 130: 1028-1034, 2001.

    Article  CAS  Google Scholar 

  7. Deeken-Draisey A, Yang GY, Gao J, Alexiev BA Anaplastic thyroid carcinoma: an epidemiologic, histologic, immunohistochemical, and molecular single-institution study. Hum Pathol 82: 140-148, 2018.

    Article  CAS  Google Scholar 

  8. Sugitani I, Kasai N, Fujimoto Y, Yanagisawa A Prognostic factors and therapeutic strategy for anaplastic carcinoma of the thyroid. World J Surg 25: 617-622, 2001.

    Article  CAS  Google Scholar 

  9. Akaishi J, Sugino K, Kitagawa W et al. Prognostic factors and treatment outcomes of 100 cases of anaplastic thyroid carcinoma. Thyroid 21: 1183-1189, 2011.

    Article  Google Scholar 

  10. Han JM, Bae Kim W, Kim TY et al. Time trend in tumour size and characteristics of anaplastic thyroid carcinoma. Clin Endocrinol (Oxf) 77: 459-464, 2012.

    Article  Google Scholar 

  11. Mohebati A, Dilorenzo M, Palmer F et al. Anaplastic thyroid carcinoma: a 25-year single-institution experience. Ann Surg Oncol 21: 1665-1670, 2014.

    Article  CAS  Google Scholar 

  12. Rao SN, Zafereo M, Dadu R et al. Patterns of treatment failure in anaplastic thyroid carcinoma. Thyroid 27: 672-681, 2017.

    Article  CAS  Google Scholar 

  13. Spires JR, Schwartz MR, Miller RH Anaplastic thyroid carcinoma. Association with differentiated thyroid cancer. Arch Otolaryngol Head Neck Surg 114: 40-44, 1988.

    Article  CAS  Google Scholar 

  14. Aldinger KA, Samaan NA, Ibanez M, Hill CS, Jr. Anaplastic carcinoma of the thyroid: a review of 84 cases of spindle and giant cell carcinoma of the thyroid. Cancer 41: 2267-2275, 1978.

    Article  CAS  Google Scholar 

  15. Choi JY, Hwang BH, Jung KC et al. Clinical significance of microscopic anaplastic focus in papillary thyroid carcinoma. Surgery 154: 106-110, 2013.

    Article  Google Scholar 

  16. Lee DY, Won JK, Lee SH et al. Changes of clinicopathologic characteristics and survival outcomes of anaplastic and poorly differentiated thyroid carcinoma. Thyroid 26: 404-413, 2016.

    Article  Google Scholar 

  17. Mete O, Seethala, R; Asa SL, et al. Protocol for the examination of specimens from patients with carcinomas of the thyroid gland. College of American Pathologists, 2019.

  18. Besic N, Hocevar M, Zgajnar J, Pogacnik A, Grazio-Frkovic S, Auersperg M Prognostic factors in anaplastic carcinoma of the thyroid-a multivariate survival analysis of 188 patients. Langenbecks Arch Surg 390: 203-208, 2005.

    Article  Google Scholar 

  19. Chen H, Luthra R, Routbort MJ et al. Molecular profile of advanced thyroid carcinomas by next-generation sequencing: characterizing tumors beyond diagnosis for targeted therapy. Mol Cancer Ther 17: 1575-1584, 2018.

    Article  CAS  Google Scholar 

  20. Sholl LM, Do K, Shivdasani P et al. Institutional implementation of clinical tumor profiling on an unselected cancer population. JCI Insight 1: e87062, 2016.

    Article  Google Scholar 

  21. Garcia EP, Minkovsky A, Jia Y et al. Validation of OncoPanel: a targeted next-generation sequencing assay for the detection of somatic variants in cancer. Arch Pathol Lab Med 141: 751-758, 2017.

    Article  CAS  Google Scholar 

  22. Wong KS, Lorch JH, Alexander EK et al. Clinicopathologic features of mismatch repair-deficient anaplastic thyroid carcinomas. Thyroid 29: 666-673, 2019.

    Article  CAS  Google Scholar 

  23. Duan H, Li Y, Hu P et al. Mutational profiling of poorly differentiated and anaplastic thyroid carcinoma by the use of targeted next-generation sequencing. Histopathology 75: 890-899, 2019.

    Article  Google Scholar 

  24. Khan SA, Ci B, Xie Y et al. Unique mutation patterns in anaplastic thyroid cancer identified by comprehensive genomic profiling. Head Neck 41: 1928-1934, 2019.

    Article  Google Scholar 

  25. Kunstman JW, Juhlin CC, Goh G et al. Characterization of the mutational landscape of anaplastic thyroid cancer via whole-exome sequencing. Hum Mol Genet 24: 2318-2329, 2015.

    Article  CAS  Google Scholar 

  26. Landa I, Ibrahimpasic T, Boucai L et al. Genomic and transcriptomic hallmarks of poorly differentiated and anaplastic thyroid cancers. J Clin Invest 126: 1052-1066, 2016.

    Article  Google Scholar 

  27. Pozdeyev N, Gay LM, Sokol ES et al. Genetic analysis of 779 advanced differentiated and anaplastic thyroid cancers. Clin Cancer Res 24: 3059-3068, 2018.

    Article  CAS  Google Scholar 

  28. Rushton S, Burghel G, Wallace A, Nonaka D Immunohistochemical detection of BRAF V600E mutation status in anaplastic thyroid carcinoma. Histopathology 69: 524-526, 2016.

    Article  Google Scholar 

  29. Sandulache VC, Williams MD, Lai SY et al. Real-time genomic characterization utilizing circulating cell-free DNA in patients with anaplastic thyroid carcinoma. Thyroid 27: 81-87, 2017.

    Article  CAS  Google Scholar 

  30. Shi X, Liu R, Qu S et al. Association of TERT promoter mutation 1,295,228 C>T with BRAF V600E mutation, older patient age, and distant metastasis in anaplastic thyroid cancer. J Clin Endocrinol Metab 100: E632-637, 2015.

    Article  CAS  Google Scholar 

  31. Tiedje V Ting S, Herold T, Synoracki S, et al. NGS based identification of mutational hotspots for targeted therapy in anaplastic thyroid carcinoma. Oncotarget 8: 42613-42620, 2017.

    Article  Google Scholar 

  32. Wu X, Yan J, Dai J et al. Mutations in BRAF codons 594 and 596 predict good prognosis in melanoma. Oncol Lett 14: 3601-3605, 2017.

    Article  Google Scholar 

  33. Wagle N, Grabiner BC, Van Allen EM et al. Response and acquired resistance to everolimus in anaplastic thyroid cancer. N Engl J Med 371: 1426-1433, 2014.

    Article  Google Scholar 

  34. Dibelius G, Mehra S, Clain JB, Urken ML, Wenig BM Noninvasive anaplastic thyroid carcinoma: report of a case and literature review. Thyroid 24: 1319-1324, 2014.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Kristine S. Wong & Justine A. Barletta

  2. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    Jochen H. Lorch

  3. Division of Endocrinology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Erik K. Alexander & Ellen Marqusee

  4. Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Nancy L. Cho, Matthew A. Nehs & Gerard M. Doherty

Authors
  1. Kristine S. Wong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jochen H. Lorch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erik K. Alexander
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ellen Marqusee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nancy L. Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Matthew A. Nehs
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gerard M. Doherty
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Justine A. Barletta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Justine A. Barletta.

Ethics declarations

Conflict of Interest

Dr. Jochen Lorch receives research support to the institution from Novartis, Bayer, Takeda, BMS and is on the advisory board of Novartis, Bayer, Genentech. All other authors have no disclosures.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wong, K.S., Lorch, J.H., Alexander, E.K. et al. Histopathologic Features and Clinical Outcome of Anaplastic Thyroid Carcinoma with a Minor Anaplastic Component. Endocr Pathol 31, 283–290 (2020). https://doi.org/10.1007/s12022-020-09627-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12022-020-09627-0

Keywords

Search

Navigation