Anaplastic thyroid cancer staging: Difference between revisions

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(2015). http://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq#link/stoc_h2_2- Accessed on October, 29 2015</ref> 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]].
(2015). http://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq#link/stoc_h2_2- Accessed on October, 29 2015</ref> 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]].
==Staging==
==Staging==
* 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 are 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]].
* 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]].<ref> Thyroid Cancer Cancer.gov
* 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]].<ref> Thyroid Cancer Cancer.gov
(2015). http://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq#section/_6- Accessed on November, 19 2015</ref>
(2015). http://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq#section/_6- Accessed on November, 19 2015</ref>
{| class="wikitable"
|+


! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Primary tumor
|-
| align="center" style="background:#f0f0f0;" |'''Tumor size'''
| align="center" style="background:#f0f0f0;" |'''Sub-stage'''
| align="center" style="background:#f0f0f0;" |'''Finding'''
|'''Image'''
|-
| T0
|  ||
* No evidence of primary [[tumor]]
|
|-
| T1
|  ||
* [[Tumor]] ≤2 cm in greatest dimension limited to the [[thyroid]]
|
|-
| T1
| a||
* [[Tumor]] ≤1 cm, limited to the [[thyroid]]
| [[Image:Diagram showing stage T1a thyroid cancer CRUK 250.png|200px|thumb|none]]
|-
| T1
| b||
* [[Tumor]] >1 cm but ≤2 cm in greatest dimension, limited to the [[thyroid]]
| [[Image:Diagram showing stage T1b thyroid cancer CRUK 251.svg.png|200px|thumb|none]]
|-
| T2
|  ||
* [[Tumor]] >2 cm but ≤4 cm in greatest dimension, limited to the [[thyroid]]
|
|-
| T3
|  ||
* [[Tumor]] >4 cm limited to the [[thyroid]], or gross extrathyroidal extension invading only strap [[muscles]]
| [[Image:Diagram showing stage T3 thyroid cancer CRUK 265.png|200px|thumb|none]]
|-
|T3
|a
|
* [[Tumor]] >4 cm limited to the [[thyroid]]
|
|-
|T3
|b
|
* Gross extrathyroidal extension invading only strap [[muscles]] ([[sternohyoid]], [[sternothyroid]], [[thyrohyoid]], or [[Omohyoid muscle|omohyoid muscles]]) from a [[tumor]] of any size
|
|-
| T4
|  ||
* [[Tumor]] includes gross extrathyroidal extension beyond the strap [[muscles]]
|
|-
| T4
| a||
* [[Tumor]] with gross extrathyroidal extension invading subcutaneous [[Soft tissue|soft tissues]], [[larynx]], [[trachea]], [[esophagus]], or [[recurrent laryngeal nerve]] from a [[tumor]] of any size
|[[Image:Diagram showing stage T4a thyroid cancer CRUK 272.png|200px|thumb|none]]
|-
| T4
| b||
* [[Tumor]] with gross extrathyroidal extension invading [[prevertebral fascia]] or encasing the [[carotid artery]] or [[mediastinal]] vessels from a [[tumor]] of any size.
|[[Image:Diagram showing stage T4b thyroid cancer CRUK 273.png|200px|thumb|none]]
|-
| TX
|  ||
* Primary [[tumor]] cannot be assessed
|
|-
|+
! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Regional lymph node involvement
|-
| align="center" style="background:#f0f0f0;" |'''Node involvement'''
| align="center" style="background:#f0f0f0;" |'''Sub-stage'''
| align="center" style="background:#f0f0f0;" |'''Finding'''
|'''Image'''
|-
| N0
| ||
* No [[lymph node]] involvement
|
|-
|N0
|a
|
* One or more cytologically or [[histologically]] confirmed benign [[lymph nodes]]
|
|-
|N0
|b
|
* No [[Radiological|radiologic]] or clinical evidence of locoregional [[lymph node]] [[metastasis]]
|
|-
| N1
|  ||
* [[Metastasis]] to regional nodes
|
|-
| N1
| a||
* [[Metastasis]] to level VI or VII ([[Pretracheal lymph nodes|pretracheal]], [[Paratracheal lymph nodes|paratracheal]], or [[Prelaryngeal lymph nodes|prelaryngeal]]/Delphian, or upper mediastinal) [[lymph nodes]]. This can be unilateral or bilateral [[disease]]
|[[Image:Diagram showing stage N1a thyroid cancer CRUK 242.png|200px|thumb|none]]
|-
| N1
| b||
* [[Metastasis]] to unilateral, bilateral, or contralateral [[Cervical lymph nodes|cervical]] neck [[lymph nodes]] (levels I, II, III, IV, or V) or [[retropharyngeal lymph nodes]]
|[[Image:Diagram showing stage N1b thyroid cancer CRUK 243.png|200px|thumb|none]]
|-
| NX
|  ||
* Regional [[lymph node]] cannot be assessed
|
|-
|+
! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Distant metastasis
|-
| align="center" style="background:#f0f0f0;" |'''Presence of metastasis'''
| align="center" style="background:#f0f0f0;" |'''Sub-stage'''
| align="center" style="background:#f0f0f0;" |'''Finding'''
|'''Image'''
|-
| M0
| ||
* No distant [[metastasis]]
|
|-
| M1
| IV||
* Distant [[metastasis]]
|[[Image:Stage M1 Thyroid cancer.png|200px|thumb|none]]
|-
|}
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+'''''Anaplastic thyroid cancer'''''
|+'''''Anaplastic thyroid cancer'''''
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|-
|-
! style="background: #DCDCDC;" |IVA
! style="background: #DCDCDC;" |IVA
! style="background: #F5F5F5;" |T4a
! style="background: #F5F5F5;" |T1–T3a


! style="background: #F5F5F5;" |N0/NX
! style="background: #F5F5F5;" |M0
|-
! rowspan="3" style="background: #DCDCDC;" |IVB
! style="background: #F5F5F5;" |T1–T3a
! style="background: #F5F5F5;" |N1
! style="background: #F5F5F5;" |M0
|-
! style="background: #F5F5F5;" |T3b
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0
|-
|-
! style="background: #DCDCDC;" |IVB
! style="background: #F5F5F5;" |T4
! style="background: #F5F5F5;" |T4b
 
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |Any N
 
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M1
|-
|-
! style="background: #DCDCDC;" |IVC
! style="background: #DCDCDC;" |IVC

Latest revision as of 20:55, 27 September 2019

Anaplastic thyroid cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Anaplastic thyroid cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

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Prevention

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Risk calculators and risk factors for Anaplastic thyroid cancer staging

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

Overview

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.

Staging

  • 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
T0
  • No evidence of primary tumor
T1
T1 a
T1 b
  • Tumor >1 cm but ≤2 cm in greatest dimension, limited to the thyroid
T2
  • Tumor >2 cm but ≤4 cm in greatest dimension, limited to the thyroid
T3
  • Tumor >4 cm limited to the thyroid, or gross extrathyroidal extension invading only strap muscles
T3 a
T3 b
T4
  • Tumor includes gross extrathyroidal extension beyond the strap muscles
T4 a
T4 b
TX
  • Primary tumor cannot be assessed
Regional lymph node involvement
Node involvement Sub-stage Finding Image
N0
N0 a
N0 b
N1
N1 a
N1 b
NX
Distant metastasis
Presence of metastasis Sub-stage Finding Image
M0
M1 IV
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

Reference

  1. ↑ Stage Information for Thyroid Cancer Cancer.gov (2015). http://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq#link/stoc_h2_2- Accessed on October, 29 2015
  2. ↑ Thyroid Cancer Cancer.gov (2015). http://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq#section/_6- Accessed on November, 19 2015
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