Abstract
Anaplastic carcinoma of the thyroid is one of the most aggressive neoplasmas encounterd in humans. A poor prognosis for this disease is well known, and death sometimes occurs within a few weeks after detection. Eight cases with anaplastic carcinomas out of 100 thyroid cancers were treated at the Department of Otorhinolaryngology, Hiroshima University during 1990∼1999. Of the 8 patients, 5 had resection with curative intent. At 2 years after treatment, only one patient is still alive. This patient underwent extended operation including total lobectomy, pharyngo-laryngectomy and esophagectomy with reconstruction using gastric transposition. Histopathological examination of resected specimens revealed anaplastic carcinoma within the papillary carcinoma. The other 7 patients died of their disease one to eight months after the first treatment. The treatment of anaplastic carcinoma is still controversial. Results of chemotherapy adopting cisplatin, G-CSF and multi-drug therapy have improved, and extended operations have been reported with better results than patients treated without operation. Although curative extended surgical treatment in patients with localized disease requires careful consideration because unsuccessful resection may lead to an advanced stage of the disease, it has been reported that adequate resection of tumors can cure some carcinomas with anaplastic changes. Unfortunately, during the past recent decade, advances in the treatment of this disease have been nominal. Considering quality of life, further study is needed to establish the most effective treatment of anaplastic thyroid carcinoma.
