Skip to main content

Anaplastic Carcinoma

  • Living reference work entry
  • First Online:
Encyclopedia of Pathology

Part of the book series: Encyclopedia of Pathology ((EP))

  • 49 Accesses

Synonyms

Carcinosarcoma; Giant cell carcinoma; Metaplastic carcinoma; Pleomorphic carcinoma; Sarcomatoid carcinoma; Spindle cell carcinoma; Undifferentiated carcinoma

Definition

Anaplastic carcinoma (AC) is a high grade follicular-derived carcinoma with pleomorphic features.

Clinical Features

  • Incidence

    It is a very rare tumor. It constitutes less than 5% of all thyroid malignancies.

  • Age

    It usually affects elderly people, with a mean age in the mid-60s.

  • Sex

    The female-to-male ratio is 2:1 (El Naggar et al. 2017).

  • Site

    It generally presents as a bulk, involving both thyroid lobes and extrathyroid tissue.

  • Treatment

    Most AC are unresectable at diagnosis; however, a surgical approach could be considered in selected patients (El Naggar et al. 2017). Therapy is often multimodal, consisting of surgery, systemic therapy, and/or radiation therapy, because AC often responds poorly to single-modality therapy (Haddad et al. 2018).

  • Outcome

    Despite its rarity, it accounts for more than half of the...

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

Access this chapter

Institutional subscriptions

References and Further Reading

  • Bishop, J. A., Sharma, R., & Westra, W. H. (2011). PAX8 immunostaining of anaplastic thyroid carcinoma: A reliable means of discerning thyroid origin for undifferentiated tumors of the head and neck. Human Pathology, 42, 1873–1877.

    Article  CAS  Google Scholar 

  • Carcangiu, M. L., Steeper, T., Zampi, G., & Rosai, J. (1985). Anaplastic thyroid carcinoma. A study of 70 cases. Journal of Clinical Pathology, 83, 135–158.

    Article  CAS  Google Scholar 

  • Carcangiu, M. L., LAm, A. K. Y., & Montone, K. T. (2017). Squamous cell carcinoma. In R. V. Lloyd, R. Y. Osamura, G. Klöppel, & J. Rosai (Eds.), WHO Classification of tumors of endocrine organs (pp. 104–106). Lyon: IARC.

    Google Scholar 

  • El Naggar, A. K., Baloch, Z. W., Eng, C., Evans, H. L., Fagin, J. A., Faquin, W. C., Fellegara, G., Franssila, K. O., Giuffrida, D., Katoh, R., kebebew, E., Kondo, T., Matias-Guiu, X., Nikiforov, Y. E., Papotti, M., Smallridge, R., Sugitani, I., Tallini, G., Wakely, P. E., Westra, W. H., Wick, M. R., & Williams, M. D. (2017). Anaplastic thyroid carcinoma. In R. V. Lloyd, R. Y. Osamura, G. Klöppel, & J. Rosai (Eds.), WHO classification of tumors of endocrine organs (pp. 104–106). Lyon: IARC.

    Google Scholar 

  • Fukushima, T., Suzuki, S., Mashiko, M., Ohtake, T., Endo, Y., Takebayashi, Y., Sekikawa, K., Hagiwara, K., & Takenoshita, S. (2003). BRAF mutations in papillary carcinomas of the thyroid. Oncogene, 25, 6455–6457.

    Article  Google Scholar 

  • Gaffey, M. J., Lack, E. E., Christ, M. L., & Weiss, l. M. (1991). Anaplastic thyroid carcinoma with osteoclast-like giant cells: A clinicopathologic, immunohistochemical, and ultrastructural study. The American Journal of Surgical Pathology, 15, 160–168.

    Article  CAS  Google Scholar 

  • Garcia-Rostan, G., Tallini, G., Herrero, A., D'Aquila, T. G., Carcangiu, M. L., & Rimm, D. L. (1999). Frequent mutation and nuclear localization of beta-catenin in anaplastic thyroid carcinoma. Cancer Research, 15, 1811–1815.

    Google Scholar 

  • Haddad, R. I., Nasr, C., Bischoff, L., Busaidy, N. L., Byrd, D., Callender, G., Dickson, P., Duh, Q. Y., Ehya, H., Goldner, W., Haymart, M., Hoh, C., Hunt, J. P., Iagaru, A., Kandeel, F., Kopp, P., Lamonica, D. M., McIver, B., Raeburn, C. D., Ridge, J. A., Ringel, M. D., Scheri, R. P., Shah, J. P., Sippel, R., Smallridge, R. C., Sturgeon, C., Wang, T. N., Wirth, L. J., Wong, R. J., Johnson-Chilla, A., Hoffmann, K. G., & Gurski, L. A. (2018). NCCN guidelines insights: Thyroid carcinoma, version 2.2018. Journal of the National Comprehensive Cancer Network, 16, 1429–1440.

    Article  Google Scholar 

  • Kuhn, E., Ragazzi, M., Ciarrocchi, A., Torricelli, F., de Biase, D., Zanetti, E., Bisagni, A., Corrado, S., Uccella, S., La Rosa, S., Bongiovanni, M., Losito, S., & Piana, S. (2019). Angiosarcoma and anaplastic carcinoma of the thyroid are two distinct entities: A morphologic, immunohistochemical, and genetic study. Modern Pathology, 32, 787–798.

    Article  CAS  Google Scholar 

  • Landa, I., Ganly, I., Chan, T. A., Mitsutake, N., Matsuse, M., Ibrahimpasic, T., Ghossein, R. A., & Fagin, J. A. (2013). Frequent somatic TERT promoter mutations in thyroid cancer: Higher prevalence in advanced forms of the disease. The Journal of Clinical Endocrinology and Metabolism, 98, E1562–E1566.

    Article  CAS  Google Scholar 

  • LiVolsi, V. A., Brooks, J. J., & Arendash-Durand, B. (1987). Anaplastic thyroid tumors. Immunohistology. American Journal of Clinical Pathology, 87, 434–442.

    Article  CAS  Google Scholar 

  • Miettinen, M., & Franssila, K. O. (2000). Variable expression of keratins and nearly uniform lack of thyroid transcription factor 1 in thyroid anaplastic carcinoma. Human Pathology, 31, 1139–1145.

    Article  CAS  Google Scholar 

  • Nikiforov, Y. E. (2004). Genetic alterations involved in the transition from well-differentiated to poorly differentiated and anaplastic thyroid carcinomas. Endocrine Pathology, 15, 319–327.

    Article  CAS  Google Scholar 

  • Nikiforova, M. N., Kimura, E. T., Gandhi, M., Biddinger, P. W., Knauf, J. A., Basolo, F., Zhu, Z., Giannini, R., Salvatore, G., Fusco, A., Santoro, M., Fagin, J. A., & Nikiforov, Y. E. (2003). BRAF mutations in thyroid tumors are restricted to papillary carcinomas and anaplastic or poorly differentiated carcinomas arising from papillary carcinomas. The Journal of Clinical Endocrinology and Metabolism, 88, 5399–5404.

    Article  CAS  Google Scholar 

  • Nishiyama, R. H., Dunn, E. L., & Thompson, N. W. (1972). Anaplastic spindle-cell and giant-cell tumors of the thyroid gland. Cancer, 30, 1113–1127.

    Article  Google Scholar 

  • Nonaka, D., Tang, Y., Chiriboga, L., Rivera, M., & Ghossein, R. (2008). Diagnostic utility of thyroid transcription factors Pax8 and TTF-2 (FoxE1) in thyroid epithelial neoplasms. Modern Pathology, 21, 192–200.

    Article  CAS  Google Scholar 

  • Ordonez, N. G., El-Naggar, A. K., Hickey, R. C., & Samaan, N. A. (1991). Anaplastic thyroid carcinoma: Immunocytochemical study of 32 cases. American Journal of Clinical Pathology, 96, 15–24.

    Article  CAS  Google Scholar 

  • Puglisi, F., Cesselli, D., Damante, G., Pellizzari, L., Beltrami, C. A., & Di Loreto, C. (2000). Expression of Pax-8, p53 and bcl-2 in human benign and malignant thyroid diseases. Anticancer Research, 20, 311–316.

    CAS  PubMed  Google Scholar 

  • Ragazzi, M., Ciarrocchi, A., Sancisi, V., Gandolfi, G., Bisagni, A., & Piana, S. (2014). Update on anaplastic thyroid carcinoma: Morphological, molecular, and genetic features of the most aggressive thyroid cancer. International Journal of Endocrinology, 14(2014), 790834.

    Google Scholar 

  • Rivera, M., Shang, C., Gerhard, R., Ghossein, R., & Lin, O. (2010). Anaplastic thyroid carcinoma: Morphologic findings and PAX-8 expression in cytology specimens. Acta Cytologica, 54, 668–672.

    Article  Google Scholar 

  • Sancisi, V., Nicoli, D., Ragazzi, M., Piana, S., & Ciarrocchi, A. (2012). BRAFV600E mutation does not mean distant metastasis in thyroid papillary carcinomas. The Journal of Clinical Endocrinology and Metabolism, 97, E1745–E1749.

    Article  CAS  Google Scholar 

  • Wan, S. K., Chan, J. K. C., & Tang, S. K. (1996). Paucicellular variant of anaplastic thyroid carcinoma: A mimic of Riedel’s thyroiditis. American Journal of Clinical Pathology, 105, 388–393.

    Article  CAS  Google Scholar 

  • Xing, M., Alzahrani, A. S., Carson, K. A., Viola, D., Elisei, R., Bendlova, B., Yip, L., Mian, C., Vianello, F., Tuttle, R. M., Robenshtok, E., Fagin, J. A., Puxeddu, E., Fugazzola, L., Czarniecka, A., Jarzab, B., O'Neill, C. J., Sywak, M. S., Lam, A. K., Riesco-Eizaguirre, G., Santisteban, P., Nakayama, H., Tufano, R. P., Pai, S. I., Zeiger, M. A., Westra, W. H., Clark, D. P., Clifton-Bligh, R., Sidransky, D., Ladenson, P. W., & Sykorova, V. (2013). Association between BRAF V600E mutation and mortality in patients with papillary thyroid cancer. JAMA, 309, 1493–1501.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Simonetta Piana .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Piana, S. (2020). Anaplastic Carcinoma. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_5259-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-28845-1_5259-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28845-1

  • Online ISBN: 978-3-319-28845-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics