Anaplastic thyroid cancer staging

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Anaplastic thyroid cancer Microchapters


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]


According to the American Joint Committee on Cancer (AJCC)[1] there are 4 stages of anaplastic thyroid cancer based on the clinical features and findings on imaging. Each stage is assigned a letter and a number that designate the tumor size, number of lymph node regions involved, and metastasis.


  • No generally accepted staging system is available for anaplastic thyroid cancer. Because the prognosis for anaplastic thyroid cancer is so poor, all anaplastic thyroid cancer is classified as stage IV according to International Union Against Cancer (UICC) staging, regardless of tumor size, nodal status, and either absence or presence of distant metastasis.
  • Undifferentiated (anaplastic) carcinomas are highly malignant cancers of the thyroid. They may be subclassified as small cell or large cell carcinomas. Both grow rapidly and extend to structures beyond the thyroid. Both small cell and large cell carcinomas present as hard, ill-defined masses, often with extension into the structures surrounding the thyroid. Small cell anaplastic thyroid carcinoma must be carefully distinguished from lymphoma. This tumor usually occurs in an older age group and is characterized by extensive local invasion and rapid progression. Five-year survival with this tumor is poor. Death is usually from uncontrolled local cancer in the neck, usually within months of diagnosis.[2]
Primary tumor
Tumor size Sub-stage Finding Image
  • No evidence of primary tumor
T1 a
Diagram showing stage T1a thyroid cancer CRUK 250.png
T1 b
  • Tumor >1 cm but ≤2 cm in greatest dimension, limited to the thyroid
Diagram showing stage T1b thyroid cancer CRUK 251.svg.png
  • Tumor >2 cm but ≤4 cm in greatest dimension, limited to the thyroid
  • Tumor >4 cm limited to the thyroid, or gross extrathyroidal extension invading only strap muscles
Diagram showing stage T3 thyroid cancer CRUK 265.png
T3 a
T3 b
  • Tumor includes gross extrathyroidal extension beyond the strap muscles
T4 a
Diagram showing stage T4a thyroid cancer CRUK 272.png
T4 b
Diagram showing stage T4b thyroid cancer CRUK 273.png
  • Primary tumor cannot be assessed
Regional lymph node involvement
Node involvement Sub-stage Finding Image
N0 a
N0 b
N1 a
Diagram showing stage N1a thyroid cancer CRUK 242.png
N1 b
Diagram showing stage N1b thyroid cancer CRUK 243.png
Distant metastasis
Presence of metastasis Sub-stage Finding Image
Stage M1 Thyroid cancer.png
Anaplastic thyroid cancer
Stage T N M
IVA T1–T3a N0/NX M0
IVB T1–T3a N1 M0
T3b Any N M0
T4 Any N M0
IVC Any T Any N M1


  1. Stage Information for Thyroid Cancer (2015). Accessed on October, 29 2015
  2. Thyroid Cancer (2015). Accessed on November, 19 2015