Management of acute clinical presentation of anaplastic thyroid cancer. A difficult choice
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Abstract
AIM: evaluate emergency treatment of patients presenting with anaplastic thyroid cancer with acute compressive sympthoms.
MATERIAL OF STUDY: In the present report, we describe three patients with anaplastic thyroid cancer who presented clinically with acute compressive sympthoms.
All patients underwent debulking surgery in order to relieve the sympthoms and perform a potentially curative resection.
RESULTS: The first two patients with diagnosis of ATC couldn’t undergo to radiotherapy and chemotherapy for the presence of infection of the wound and for the earlier disease relapse in the mediastinum and died after 1 month and 3 months. The third patient (with papillary thyroid cancer with focal areas of anaplastic cancer) after surgical treatment underwent external radiotherapy and is alive over 2 years.
DISCUSSION: Compression, deviation, and infiltration of trachea have impeded the achievement of a safe respiratory access with tracheostomy and these three patients underwent debulking surgery to relieve compressive sympthoms.
These three cases confirm the importance of acute local compressive symptoms of ATC and their difficult management.
CONCLUSIONS: In such cases a debulking surgery can be considered as a valid option in the emergency management. Nevertheless debulking surgery (and even radical excision of the tumor), when performed alone, offer a minimal improved survival.