[Anaplastic carcinoma of the thyroid at the Instituto Nacional de la Nutrición Salvador Zubirán].
BACKGROUND
Anaplastic thyroid carcinoma (ATC) is a highly aggressive tumor with a median survival rate of 6 months.


OBJECTIVE
To analyze presentation, treatment, morphology, immunohistochemistry, and nuclear DNA analysis of a cohort of patients with ATC.


METHODS
Twelve patients with ATC (11 female) with a mean age of 65 years were seen at our hospital from 1970-1995. The data were obtained from the clinical records and the morphology, immunohistochemic studies and DNA pattern were performed in slides obtained from archival specimens.


RESULTS
Previous or coexisting thyroide disease was documented in 10 patients (9 multinodular goiters and one Grave's). The most frequent presentation was a rapidly growing tumor associated with dysphagia, cervical pain, hoarseness and dyspnea. A cold thyroid nodule was detected by thyroid scan in 10 patients. The most frequent subtype was the spindle cell variety. Papillary thyroid carcinoma coexisted in eight cases, two of them corresponded to the tall cell variant. Reactivity for S-100 protein and vimentin was studied in six patients: all were positive for S-100 protein and vimentin, 5/6 for epithelial membrane antigen, half for carcinoembriogenic antigen, 2/6 for thyroglobulin and calcitonin, and one for neuronal specific enolase. These six tumors showed a diploid DNA pattern. Tumor resection was achieved in 2/11 and none survived six years after diagnosis.


CONCLUSIONS
ATC is a highly aggressive tumor coexisting with thyroid pathologies. Spindle cell variant is the most frequent with positive reactivity for S-100 protein, vimentin and epithelial membrane antigen. Most tumors have a diploid DNA content.
Sierra
M
M
Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Gamboa-Domínguez
A
A
Herrera
M F
MF
Barredo-Prieto
B
B
Alvarado de la Barrera
C
C
Llorente
L
L
Pérez-Enriquez
B
B
Rivera
R
R
González
O
O
Rull
J A
JA
D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D002277:Carcinoma / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D002291:Carcinoma, Papillary / Q000453:epidemiology; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004273:DNA, Neoplasm / Q000235:genetics; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D015993:Life Tables; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D013965:Thyroidectomy; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D007457:Iodine Radioisotopes