Annals of Surgical Oncology

, Volume 14, Issue 10, pp 3011–3018

Anaplastic Carcinoma of the Thyroid Arising More Often from Follicular Carcinoma than Papillary Carcinoma


  • Hwei-Ming Wang
    • Division of Colorectal Surgery, Department of SurgeryTaichung Veterans General Hospital
  • Yu-Wen Huang
    • Department of Medical ResearchMackay Memorial Hospital
  • Jen-Seng Huang
    • Division of Hematology/Oncology, Department of Internal MedicineChang Gung Memorial Hospital
  • Cheng-Hsu Wang
    • Division of Hematology/Oncology, Department of Internal MedicineChang Gung Memorial Hospital
  • Victor C. Kok
    • Division of Medical OncologyKuang Tien General Hospital
  • Chao-Ming Hung
    • Department of General SurgeryE-da Hospital
  • Han-Ming Chen
    • Department of SurgeryTen-Chan Hospital
    • Department of PathologyMackay Memorial Hospital
    • Mackay Medicine, Nursing and Management College
    • National Taipei College of Nursing
Endocrine Tumors

DOI: 10.1245/s10434-007-9503-8

Cite this article as:
Wang, H., Huang, Y., Huang, J. et al. Ann Surg Oncol (2007) 14: 3011. doi:10.1245/s10434-007-9503-8



Anaplastic thyroid carcinoma (ATC), a rare and highly malignant tumor, has long been thought to arise from well-differentiated carcinoma (WDC) such as follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC). The purpose of this study was to test this notion by examining whether and, if so, how often ATC harbors the oncogenes that are commonly associated with WDC, such as RAS in FTC and BRAF in PTC.


We analyzed the mutation hotspots of BRAF (codon 600) and N-, K-, and H-RAS (codons 12, 13, and 61) in 16 ATCs. We also examined two genes, PIK3CA (exons 9 and 20) and TP53 (exons 5–9), both of which have been reported in ATCs.


The results showed that approximately 31% (5 of 16) of ATCs harbored N-RAS mutation, 6% (1 of 16) had mutated BRAF, and approximately 56% (9 of 16) had mutated TP53. As to the three ATCs that had coexisted PTCs, mutated BRAF was detected in all PTC components but only in one ATC, while mutated PIK3CA was found in only one PTC component but not in the ATC.


A number of ATCs arise from WDCs, more often from RAS-mutant tumors than from BRAF-mutant tumors, implying that particular attention should be paid to the WDC harboring RAS mutation.


Anaplastic thyroid carcinomaFollicular thyroid carcinomaPapillary thyroid carcinomaBRAF mutationN-RAS mutationTP53 mutation

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© The Society of Surgical Oncology, Inc. 2007