open access

Vol 61, No 5 (2010)
Original papers
Published online: 2010-11-04
Submitted: 2013-02-15
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The clinical course of poorly differentiated thyroid carcinoma (insular carcinoma) - own observations

Agnieszka Walczyk, Aldona Kowalska, Jacek Sygut
Endokrynologia Polska 2010;61(5):467-473.

open access

Vol 61, No 5 (2010)
Original papers
Published online: 2010-11-04
Submitted: 2013-02-15

Abstract


Introduction: Poorly differentiated thyroid carcinoma (PDTC, insular carcinoma) occurs rarely. It is described with more aggressive behaviour, poorer prognosis, and higher mortality than well differentiated thyroid carcinoma (WDTC). The aim of this study was to evaluate the clinical course of patients with PDTC, in addition to frequency, clinical stage at the time of diagnosis and the possibility of radical surgical resection, the necessity and kind of complementary treatment, occurrence of distant metastases, and the survival of patients.
Material and methods: The study involved 14 patients (9 females, 5 males) diagnosed and treated for PDTC between 2000 and 2009, aged 38 to 78 years. The medical records of patients with PDTC were analyzed to estimate assumed parameters according to the purpose of the study.
Results: PDTC was diagnosed in 14 among 801 patients with thyroid carcinoma (1.75%). Clinical stages (UICC 2002) at the time of diagnosis were as follows: 3 patients - pT1-2No-xMx (21.5%); 10 patients - pT3 4Nx o 1Mx-1(71.4%); and 1 was unresectable - TxN1M1 (7.1%). Total thyroidectomy was achieved in 9 patients (64.3%), and 4 patients (28.6%) received non radical surgery. Complementary radioiodine treatment was given to 12 patients (85.8%). Radiation therapy of the neck was applied to 7 patients, palliative radiotherapy of the brain to 1 patient, and chemotherapy to 1 patient. Distant metastases to the lung and to the brain at diagnosis were observed in 2 patients (14.3%). During follow-up of 3-62 months lung metastases were observed in 4 patients (28.6%), three patients were observed above 5 years as disease-recurrence free (21.5%), but in one patient after 5 years and 2 months distant metastases were diagnosed. Three patients died after 2-30 months (21.5%), 2 patients were lost for control, and in the remaining 6 follow-up lasted for less than 5 years.
Conclusions: Poorly differentiated thyroid carcinoma is still a challenge both for pathologists and clinicians. Infrequent prevalence, more aggressive course, and poorer prognosis constitute major problems for the clinicians.
(Pol J Endocrinol 2010; 61 (5): 467-473)

Abstract


Introduction: Poorly differentiated thyroid carcinoma (PDTC, insular carcinoma) occurs rarely. It is described with more aggressive behaviour, poorer prognosis, and higher mortality than well differentiated thyroid carcinoma (WDTC). The aim of this study was to evaluate the clinical course of patients with PDTC, in addition to frequency, clinical stage at the time of diagnosis and the possibility of radical surgical resection, the necessity and kind of complementary treatment, occurrence of distant metastases, and the survival of patients.
Material and methods: The study involved 14 patients (9 females, 5 males) diagnosed and treated for PDTC between 2000 and 2009, aged 38 to 78 years. The medical records of patients with PDTC were analyzed to estimate assumed parameters according to the purpose of the study.
Results: PDTC was diagnosed in 14 among 801 patients with thyroid carcinoma (1.75%). Clinical stages (UICC 2002) at the time of diagnosis were as follows: 3 patients - pT1-2No-xMx (21.5%); 10 patients - pT3 4Nx o 1Mx-1(71.4%); and 1 was unresectable - TxN1M1 (7.1%). Total thyroidectomy was achieved in 9 patients (64.3%), and 4 patients (28.6%) received non radical surgery. Complementary radioiodine treatment was given to 12 patients (85.8%). Radiation therapy of the neck was applied to 7 patients, palliative radiotherapy of the brain to 1 patient, and chemotherapy to 1 patient. Distant metastases to the lung and to the brain at diagnosis were observed in 2 patients (14.3%). During follow-up of 3-62 months lung metastases were observed in 4 patients (28.6%), three patients were observed above 5 years as disease-recurrence free (21.5%), but in one patient after 5 years and 2 months distant metastases were diagnosed. Three patients died after 2-30 months (21.5%), 2 patients were lost for control, and in the remaining 6 follow-up lasted for less than 5 years.
Conclusions: Poorly differentiated thyroid carcinoma is still a challenge both for pathologists and clinicians. Infrequent prevalence, more aggressive course, and poorer prognosis constitute major problems for the clinicians.
(Pol J Endocrinol 2010; 61 (5): 467-473)
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Keywords

poorly differentiated thyroid carcinoma; insular carcinoma; prognosis; therapy

About this article
Title

The clinical course of poorly differentiated thyroid carcinoma (insular carcinoma) - own observations

Journal

Endokrynologia Polska

Issue

Vol 61, No 5 (2010)

Pages

467-473

Published online

2010-11-04

Bibliographic record

Endokrynologia Polska 2010;61(5):467-473.

Keywords

poorly differentiated thyroid carcinoma
insular carcinoma
prognosis
therapy

Authors

Agnieszka Walczyk
Aldona Kowalska
Jacek Sygut

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