Article Figures & Data
Figures
- Fig 1.
Anaplastic thyroid carcinoma characteristics.
- Fig 2.
A 60-year-old man with history of neck pain for 1 month and neck CT demonstrating a large left neck mass biopsied as anaplastic thyroid cancer, stage IVC. A, CECT demonstrates a heterogeneously enhancing solid tumor involving the left thyroid lobe and isthmus, with extension to the tracheoesophageal groove and esophageal invasion (arrow). B, Tumor encases the internal carotid artery (large white arrow), and there is direct extension to the prevertebral space, supraglottis (small white arrow), oropharynx, and floor of mouth (black arrow). C, FDG-PET shows intense radiotracer uptake within the left neck tumor with extension to the mediastinum, and there, nodal metastasis to the right neck. D, Pretreatment sonography with Doppler demonstrates a hypoechoic, solid, diffusely infiltrative mass involving the left lobe with increased vascular flow.
- Fig 3.
Anaplastic thyroid carcinoma propensity for organ invasion and vascular involvement.
- Fig 4.
A 60-year-old man with enlarging right neck mass and hoarseness for 2 months with core biopsy demonstrating ATC, stage IVC. A, Graphic demonstrating the critical areas of evaluation to characterize the local invasiveness of an aggressive thyroid mass. B, Solid, heterogeneously enhancing right lobe tumor invades the trachea and esophagus, with leftward displacement of the midline structures, and encasement of the right ICA (arrow). C, Histologic features show enlarged, pleomorphic giant cells with hyperchromatic nuclei growing in sheets consistent with ATC. Necrosis with inflammation is common in these tumors as seen in the upper portion of this picture (hematoxylin-eosin tissue section at 200× magnification). D, After systemic therapy, the tumor mass has significantly decreased in size, with increased central necrosis, and improved overall local invasiveness. The right ICA is no longer encased (white arrow), and the tumor is now separable from the esophagus (black arrow).
- Fig 5.
A, Lymphoma: CECT demonstrates a homogeneously enhancing mass diffusely enlarging the right thyroid lobe (small arrows) without calcification or necrosis. There is displacement of midline structures without organ invasion. Enlarged right level IV node (large arrow) enhances homogeneously without calcification, necrosis, or cystic change. B, Papillary thyroid carcinoma: CECT demonstrates a heterogeneously enhancing right thyroid lobe mass (black arrow) with foci of calcification and without necrosis, displacing the midline structures toward the left without organ invasion. Metastatic right level IV node (white arrow) demonstrates calcification and cystic change. C, Anaplastic thyroid carcinoma: CECT demonstrates a necrotic right thyroid lobe mass (small white arrow) directly invading the esophagus (large white arrow) and internal jugular vein (black arrow), and there is encasement of the common carotid artery.
- Fig 6.
A 64-year-old woman with fine-needle aspiration of left level IV node demonstrating anaplastic thyroid carcinoma, stage IVB. Patient subsequently underwent thyroidectomy, and surgical pathology demonstrated anaplastic thyroid carcinoma arising within papillary thyroid carcinoma. A, Preoperative CECT demonstrates heterogeneously enhancing nodule within the left thyroid lobe with calcification likely corresponding to the pre-existing papillary thyroid carcinoma (black arrow). Necrotic tumor within the anteromedial aspect of the left lobe (small white arrow) may be invading the trachea and likely corresponds to the anaplastic component seen at final pathology. Metastatic left level IV node demonstrates a necrotic focus (large white arrow). B, There is tumor thrombus within the internal jugular vein (arrows). C, Patient underwent total thyroidectomy and bilateral neck dissection, including resection of the left internal jugular vein.
