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- W2921994823 abstract "Anaplastic thyroid carcinoma (ATC) is a rare, aggressive form of thyroid malignancy with a dismal prognosis regardless of treatment. Most patients present with symptoms including a rapidly expanding central neck mass, dysphagia, hoarseness, and stridor. Metastasis is found in approximately 50% of patients at time of diagnosis. Gastrointestinal metastasis of thyroid carcinoma is exceedingly rare. We report a case of thyroid malignancy metastasizing to the esophagus. A 78-year-old woman with history of unknown thyroid malignancy treated in Mexico with thyroidectomy as well as radiation and radioactive iodine, presented with weight loss, night sweats, cough, hoarseness and dysphagia for solids. Two years prior to development of these symptoms imaging revealed several lung nodules. Repeat imaging revealed a large esophageal mass. EGD revealed a near obstructing lesion in the proximal esophagus, 3 cm from the oropharynx. Biopsy revealed anaplastic carcinoma of thyroid origin with osteoclast-like giant cells. Molecular testing was positive for BRAF mutation. PET CT scan demonstrated uptake in the esophagus, lungs, and the right retropharyngeal area. The patient was referred to a cancer center for evaluation of potential treatment options. Thyroid cancer accounts for almost 3% of all malignancies, of which ATC comprises only 1-2%. It accounts for more than half of deaths from thyroid cancer with a mortality rate over 90%. It occurs most frequently in elderly females. Most metastasis involves the lungs, bone, and brain. Gastrointestinal malignancies of ATC are very rare and have only been reported in a small number of case reports. BRAF mutations, such as the one found in our patient are found in both papillary (27.3-87.1%) and anaplastic thyroid cancers (25%). Several case reports demonstrate that patients with papillary thyroid cancer can have an aggressive transformation to anaplastic malignancy, such as what we believe occurred in our patient as two years passed between initial cancer diagnosis and recurrence, as well as the presence of BRAF mutation. Limited treatment options exist but have very poor results. Doxorubicin and cisplatin have been used as chemotherapeutic options for many years. New therapies are focused on paclitaxel plus platinum therapy. As most patients present with advanced disease, treatment options are often focused on palliative surgical measures to reduce airway obstruction, followed by chemo-radiotherapy.2961_A Figure 1. Needle core biopsy of left neck mass showing neoplasm with osteoclast-like giant cells, favoring anaplastic carcinoma of thyroid origin2961_B Figure 2. CT chest with and without contrast demonstrating a large superior mediastinal, esophageal mass measuring 66 x 40 x 27 mm2961_C Figure 3. EGD demonstrating a near obstructing lesion in the proximal esophagus, 3 cm from the oropharynx" @default.
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- W2921994823 date "2018-10-01" @default.
- W2921994823 modified "2023-09-27" @default.
- W2921994823 title "Anaplastic Thyroid Cancer Metastasizing to the Esophagus" @default.
- W2921994823 doi "https://doi.org/10.14309/00000434-201810001-02960" @default.
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