Undifferentiated thyroid carcinoma – An unusual case

Abstract

Introduction: The undifferentiated carcinoma accounts about 1.6 to 14% of all thyroid malignancies. It is an extremely aggressive cancer with poor prognosis, with metastasis at diagnosis in 20-75% of the patients and a median survival of four to 12 months.

Case: Women of 83 years, seen in consult by left cervical adenopathic mass. It was performed puncture biopsy, which revealed a papillary thyroid carcinoma. Posteriorly in the biopsy site, appeared a vegetative lesion, leading to a total thyroidectomy with cervical lymphadenectomy, which was radical at the left and modified at the right, excision of the vegetative lesion and reconstruction of the residual lesion with a delto-pectoral flap. The histology showed an undifferentiated thyroid carcinoma. Thirteen months after, arose an ulcerated right axillary nodule. We carried out excision with radical axillary lymphadenectomy, showing a metastatic carcinoma of the thyroid. After five months, appeared a right submammary cutaneous nodule, which was excised, revealing a new metastasis. In a setback of 47 months the patient remained free from detectable disease.

Discussion: We present this case because of the unique biological evolution of this tumor and the long survival presented by the patient, unusual in these cases.

Keywords: Anaplastic Carcinoma; Undifferentiated Carcinoma; Thyroid Neoplasms.