title: Is an aggressive approach justified in the management of an aggressive cancer--the squamous cell carcinoma of thyroid?
abstract: BACKGROUND
  Primary squamous cell carcinoma of the thyroid is an extremely rare neoplasm, with less than 50 cases reported in the world literature. The prognosis is poor with a median survival of less than six months. The death is usually secondary to progression of local disease as distant metastases are rare.
  
  
  METHODS
  Three cases, two males and one female presenting with sudden increase in the size of long standing thyroid swellings and associated pressure effects on the aero-digestive tract are reported. Exhaustive clinical, endoscopic, and radiological examinations did not reveal any primary site of squamous-cell carcinoma as the likely source of the metastases, or of any contiguous spread from neighboring structures. Two cases were managed by combined modality therapy including curative surgery with radiotherapy and one by radiotherapy alone.
  
  
  CONCLUSIONS
  Primary squamous cell carcinoma is a rare malignancy with a poor outcome inspite of combined modality therapy. Out of three reported cases, two succumbed to their disease within less than one year. Aggressive surgery in the form of curative resection along with adjuvant radiotherapy is recommended, the tumor being chemo resistant.
authors.affiliation: Department of Surgery, Vardhman Mahavir Medical College, Safdarjang hospital, New Delhi, India. chintamani7@rediffmail.com
authors.lastname: Chintamani
authors.forename: Pranjal
authors.initials: P
authors.lastname: Kulshreshtha
authors.forename: Jaiprakash
authors.initials: J
authors.lastname: Singh
authors.forename: Nidhi
authors.initials: N
authors.lastname: Sugandhi
authors.forename: Anju
authors.initials: A
authors.lastname: Bansal
authors.forename: Dinesh
authors.initials: D
authors.lastname: Bhatnagar
authors.forename: Sunita
authors.initials: S
authors.lastname: Saxena