title: Anaplastic thyroid cancer: a case report of a long term survival patient and review of literature data.
abstract: Anaplastic thyroid carcinoma (ATC) is a very rare disease accounting for less than 2% of all thyroid malignancies and associated to a dismal prognosis. The median survival is between 3 to 9 months with less than 10% of patients alive at 3 years after the time of diagnosis. This low cure rate is due to the late clinical presentation as a bulky unresectable tumour mass often associated with synchronous lung metastases (20-50%). A multimodality treatment consisting in a radical surgery followed by radiotherapy and chemotherapy is reported to be associated with better clinical outcomes while young age (< 65 years), tumour size (< 6.5 cm) and absence of distant metastases at time of diagnosis are recognized as strong prognostic factors of survival. We report the case of a 65 year-old man who was referred to our hospital for an ATC which extended to the external right tracheal wall and muscolar layer of esophagus. The patient underwent radical thyroidectomy with bilateral neck dissection followed by 3 cycles of adjuvant chemotherapy (Cisplatin /Epirubicin) and subsequent radiochemotherapy with Cisplatin as radiosensitizer. At more than 6 years since diagnosis the patient is still alive without evidence of local recurrence or distant metastases. Therefore, aggressive multimodality treatment after radical surgery might improve clinical outcomes and perhaps should be tested in prospective clinical trials.
authors.affiliation: Department of Radiation Oncology, S.Chiara University Hospital, Pisa, Italy. stefano.ursino@med.unipi.it.
authors.forename: S
authors.initials: S
authors.lastname: Ursino
authors.forename: F
authors.initials: F
authors.lastname: Fiorica
authors.forename: A
authors.initials: A
authors.lastname: Stefanelli
authors.forename: M
authors.initials: M
authors.lastname: Pedriali
authors.forename: C
authors.initials: C
authors.lastname: Colosimo
authors.forename: P
authors.initials: P
authors.lastname: Cocuzza
authors.forename: V
authors.initials: V
authors.lastname: Mazzotti
authors.forename: R
authors.initials: R
authors.lastname: Taibi
authors.forename: F
authors.initials: F
authors.lastname: Cartei
authors.forename: C
authors.initials: C
authors.lastname: Greco
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D065646:Thyroid Carcinoma, Anaplastic / Q000473:pathology / Q000628:therapy*; D013964:Thyroid Neoplasms / Q000473:pathology / Q000628:therapy*; D013965:Thyroidectomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D015251:Epirubicin; D002945:Cisplatin