Jornal de Distúrbios e Terapia da Tireóide
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Anaplastic Cancer and Papillary Thyroid Cancer in the same Patient: Is it a Co-Incidence or a Process of Transformation? A Case Report

Gulfem Kaya, Sefika Burcak Polat, Ersin Gurkan Dumlu, Hayriye Tatli, Reyhan Unlu Ersoy and Bekir Cakir

Anaplastic carcinoma of the thyroid gland is rare, but very aggressive, and the median survival is 3–5 months after establishing the diagnosis. The annual incidence in the USA is 1-2 cases per million populations. However, its incidence appears to be decreasing, while that of well-differentiated thyroid cancer is increasing. This report presents a patient with anaplastic thyroid cancer together with papillary carcinoma. A 62-year-old male visited our endocrinology clinic with a lump on the neck, palpable lymph nodes, and symptoms of compression. Fine-needle aspiration biopsies were inconclusive and he underwent surgery. Histopathology revealed intrathyroidal anaplastic carcinoma and papillary carcinoma in two distinct foci. Given the aggressive nature of the disease, there are few data on the tumor biology of anaplastic cancers; nevertheless, it is known that well-differentiated cancers of the thyroid gland can transform into anaplastic cancer. This results from point mutations in tumor suppressor genes due to previous radioactive iodine treatment or radiation exposure. It is not known whether de novo anaplastic cancers behave differently than those that evolved from differentiated cancers. By understanding the underlying pathophysiology of the disease, we can develop new therapies.