ABSTRACT
This chapter discusses the diagnosis and management of anaplastic thyroid cancer’s (ATCs) and primary thyroid lymphomas (PTL). Aggressive tumors such as ATC and PTL tend to present similarly, most often with a symptomatic rapidly growing neck mass requiring expeditious evaluation, diagnosis, and therapy. In single institutional studies, the presence of differentiated thyroid cancer (DTC) component, younger patient age, and earlier tumor stage at the time of diagnosis have been associated with better prognosis. ATC primary tumors are typically hard, poorly circumscribed, and fixed to surrounding structures. In the Mayo Clinic series, 60% presented as a multinodular goiter and 38% presented as an apparently unifocal thyroid mass; only 2% caused diffuse thyroid enlargement. Diagnostic scanning with radioiodine is not indicated in ATC and can delay diagnosis, but it is sometimes helpful later in the disease course in the event of recurrent coexistent DTC.
