THIEME
Contrast-Enhanced Ultrasound of Anaplastic Thyroid Cancer: A Case Report and Review of the Literature Introduction
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Anaplastic thyroid cancer (ATC) is a very rare tumor that is associated with a high mortality rate (Nagaiah G et al. J Oncol 2011; 2011:542358). The majority of patients die within one year of diagnosis (Nagaiah G et al. 2011). The incidence, estimated to be around 1–2 cases per million/year, increases with age and peaks in the sixth and seventh decades of life. ATC represents approximately 2–5 % of all cases of thyroid cancer and it is most prevalent in areas of iodine deficiency. In fact, many patients have a long clinical history of goiter and it has been hypothesized that prolonged TSH stimulation may be responsible for the transformation of a previously differentiated thyroid neoplasia into ATC. The histologic patterns of ATC include giant-cell, spindle-cell and squamoid-cell tumors. These subtypes frequently coexist and are not predictive of patient outcome. Histologically, approximately 20–30 % of ATC cases show areas of necrosis and hemorrhage. Extensive coagulative necrosis with irregular borders is often seen. Infiltration of vascular walls is accompanied by obliteration of the vascular lumina (The International Agency for Research on Cancer, Pathology and Genetics of Tumours of Endocrine Organs 2004, 77–80). We report a case of ATC studied with conventional B-mode ultrasound (US), color Doppler (CD) and contrast-enhanced ultrasonography (CEUS), and confirmed by fine needle-aspiration biopsy (FNAB). To the best of our knowledge according to the electronic database research (Pubmed), this is the first case reported in the literature describing the appearance of ATC at CEUS.
Case Description
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A 62-year-old woman was referred to our institution for an ultrasound of a palpable neck mass detected by physical examinaLicense terms
tion. The patient had normal levels of thyroid hormones and no history of previous surgery, radioactive iodine therapy, thyroid hormone suppression or family history of thyroid cancer. Conventional Bmode US was performed with a linear probe (5–13 MHz) and an Alpha 10 ultrasound machine (Aloka, Tokyo, Japan). The examination showed a heterogeneously hypoechoic solitary nodule with a maximum diameter of 3 cm and irregular margins. There was no significant internal vascularity on color Doppler, but a few large peripheral vessels were noted in the surrounding thyroidal parenchyma ▶ Fig. 1). 3 ipsilateral round lymph nodes ( ● measuring
Contrast-Enhanced Ultrasound of Anaplastic Thyroid Cancer: A Case Report and Review of the Literature Introduction
▼
Anaplastic thyroid cancer (ATC) is a very rare tumor that is associated with a high mortality rate (Nagaiah G et al. J Oncol 2011; 2011:542358). The majority of patients die within one year of diagnosis (Nagaiah G et al. 2011). The incidence, estimated to be around 1–2 cases per million/year, increases with age and peaks in the sixth and seventh decades of life. ATC represents approximately 2–5 % of all cases of thyroid cancer and it is most prevalent in areas of iodine deficiency. In fact, many patients have a long clinical history of goiter and it has been hypothesized that prolonged TSH stimulation may be responsible for the transformation of a previously differentiated thyroid neoplasia into ATC. The histologic patterns of ATC include giant-cell, spindle-cell and squamoid-cell tumors. These subtypes frequently coexist and are not predictive of patient outcome. Histologically, approximately 20–30 % of ATC cases show areas of necrosis and hemorrhage. Extensive coagulative necrosis with irregular borders is often seen. Infiltration of vascular walls is accompanied by obliteration of the vascular lumina (The International Agency for Research on Cancer, Pathology and Genetics of Tumours of Endocrine Organs 2004, 77–80). We report a case of ATC studied with conventional B-mode ultrasound (US), color Doppler (CD) and contrast-enhanced ultrasonography (CEUS), and confirmed by fine needle-aspiration biopsy (FNAB). To the best of our knowledge according to the electronic database research (Pubmed), this is the first case reported in the literature describing the appearance of ATC at CEUS.
Case Description
▼
A 62-year-old woman was referred to our institution for an ultrasound of a palpable neck mass detected by physical examinaLicense terms
tion. The patient had normal levels of thyroid hormones and no history of previous surgery, radioactive iodine therapy, thyroid hormone suppression or family history of thyroid cancer. Conventional Bmode US was performed with a linear probe (5–13 MHz) and an Alpha 10 ultrasound machine (Aloka, Tokyo, Japan). The examination showed a heterogeneously hypoechoic solitary nodule with a maximum diameter of 3 cm and irregular margins. There was no significant internal vascularity on color Doppler, but a few large peripheral vessels were noted in the surrounding thyroidal parenchyma ▶ Fig. 1). 3 ipsilateral round lymph nodes ( ● measuring
