Olthof Marijke, Persoon Adrienne C M, Plukker John T M, van der Wal Jacqueline E, Links Thera P
Universitary Medical Centre Groningen, Groningen, The Netherlands.
Endocr Pathol. 2008 Spring;19(1):62-5. doi: 10.1007/s12022-008-9017-3.
Anaplastic thyroid carcinoma is a rare and highly malignant disease. Usually, this type of tumor is irresectable, and almost all patients die within 1 year after diagnosis. We present a case of anaplastic thyroid carcinoma with rhabdomyoblastic differentiation and good therapeutic outcome. A 76-year-old female was referred to our hospital with a growing, painless neck mass which existed for 3 months. Biopsy of the mass showed microscopically and immunohistochemically a follicular (Hürthle cell) carcinoma of the thyroid, dedifferentiated to an anaplastic carcinoma with divergent differentiation along rhabdomyoblastic cell lines. The patient underwent a total thyroidectomy with additional lymph node dissection, followed by two episodes of 150 mC I(131) therapy and external radiotherapy. After a follow-up of 3 years, the patient still remains in a good condition without any signs of recurrent disease. Other cases of rhabdomyoblastic and rhabdoid anaplastic thyroid carcinomas have been described. Both types of carcinoma are associated with an aggressive clinical course. In our case, the patient is still alive without evidence of disease 3 years after primary therapy. The good clinical outcome of our patient suggests that surgical resection, radiotherapy, and I-131 ablation therapy with curative intent seems to be an adequate treatment option in patients with anaplastic thyroid carcinoma with rhabdoid and rhabdomyoblastic differentiation.
间变性甲状腺癌是一种罕见的高恶性疾病。通常，这类肿瘤无法切除，几乎所有患者在诊断后1年内死亡。我们报告一例具有横纹肌母细胞分化且治疗效果良好的间变性甲状腺癌病例。一名76岁女性因颈部肿物增大且无痛3个月前来我院就诊。肿物活检在显微镜下及免疫组化显示为甲状腺滤泡性（许特莱细胞）癌，已去分化为具有沿横纹肌母细胞系不同分化的间变性癌。患者接受了全甲状腺切除术及额外的淋巴结清扫术，随后进行了两次150mCi碘 - 131治疗和外照射放疗。经过3年随访，患者仍状况良好，无任何疾病复发迹象。此前已有横纹肌母细胞性和横纹肌样间变性甲状腺癌的其他病例报道。这两种类型的癌均与侵袭性临床病程相关。在我们的病例中，患者在初次治疗3年后仍存活且无疾病证据。我们患者良好的临床结果表明，对于具有横纹肌样和横纹肌母细胞分化的间变性甲状腺癌患者，以治愈为目的的手术切除、放疗及碘 - 131消融治疗似乎是一种合适的治疗选择。
