Queries regarding “Anaplastic Thyroid Carcinoma: Spot Diagnosis”

Compal Chauhan¹https://orcid.org/0000-0002-0691-4765, Nitisha Sharma²https://orcid.org/0000-0003-2476-3187, Manisha Kumari³https://orcid.org/0000-0002-7218-4190

¹Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India

²Department of Forensic Medicine, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India

³Department of Surgical Oncology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India

Corresponding Author: Manisha Kumari, Department of Surgical Oncology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India, Phone: +91 9992525807, e-mail: y07adavmanisha@gmail.com

How to cite this article: Chauhan C, Sharma N, Kumari M. Queries regarding “Anaplastic Thyroid Carcinoma: Spot Diagnosis”. Indian J Endoc Surg Res 2022;17(2):72.

Source of support: Nil

Conflict of interest: None

Received on: 15 June 2022; Accepted on: 22 October 2022; Published on: 30 December 2022

ABSTRACT

Anaplastic thyroid cancer (ATC) is one of the most aggressive solid organ cancers with high mortality. Even after so much progress in chemotherapy, radiotherapy, and surgical techniques, we lose almost all patients within 2 years of diagnosis. The very low threshold for suspecting ATC and Prompt diagnosis are crucial factors in the management of ATC.

Keywords: Anaplastic thyroid carcinoma, Endocrine cancer, Pemberton maneuver.

We had the opportunity to read your article “Anaplastic Thyroid Carcinoma: Spot Diagnosis.”^1,2 At the outset, we congratulate the author for highlighting the importance of time in the management of ATC. We have some queries to ask.

The authors mentioned that the patient had difficulty in breathing, hoarseness of voice, and there were prominent veins over the anterior chest wall. The authors also mentioned that the mass was extending into the thoracic inlet and therefore thoracic outlet obstruction is likely to be present in this case. Whenever there is a suspicion of thoracic outlet obstruction, one should check for Pemberton’s sign. So we want to ask what were the findings of the Pemberton’s sign if it was elicited.³
The authors also mentioned that there was a deviation of the trachea to the left and there may be an underlying tracheal obstruction in this case. Tracheal obstruction is the most common cause of death in these types of patients.⁴ Whether the authors checked for Kocher’s test, and what were the findings?
We can understand that in a government set up patients have to face a long waiting for computed tomography (CT) scan and magnetic resonance imaging (MRI). The CT scan and MRI are very useful tools for staging the ATC^5,6 However, ultrasonography (USG) can be done quickly if there is urgency. We want to know the experience of authors in predicting ATC on USG.

ORCID

Compal Chauhan https://orcid.org/0000-0002-0691-4765

Nitisha Sharma https://orcid.org/0000-0003-2476-3187

Manisha Kumari https://orcid.org/0000-0002-7218-4190

REFERENCES

1. Liu TR, Xiao ZW, Xu HN, et al. Treatment and prognosis of anaplastic thyroid carcinoma: A clinical study of 50 Cases. PLoS One 2016;11(10):e0164840. DOI: 10.1371/journal.pone.0164840.

2. Meti-Raghava MH, Kumar C. Anaplastic thyroid carcinoma: Spot diagnosis. Indian J Endoc Surg Res 2021;16(2):89–90. DOI: 10.5005/jp-journals-10088-11168.

3. Brennan M, French J. Thyroid lumps and bumps. Aust Fam Physician 2007;36(7):531–536. PMID: 17619669.

4. Broome JT, Gauger PG, Miller BS, et al. Anaplastic thyroid cancer manifesting as new-onset Horner syndrome. Endocr Pract 2009;15(6):563–566. DOI: 10.4158/EP09106.CRR.

5. Takashima S, Morimoto S, Ikezoe J, et al. CT evaluation of anaplastic thyroid carcinoma. AJR Am J Roentgenol 1990;154(5):1079–1085. DOI: 10.2214/ajr.154.5.2108546.

6. Ng TSC, Gunda V, Li R, et al. Detecting immune response to therapies targeting PDL1 and BRAF by using ferumoxytol MRI and macrin in anaplastic thyroid Cancer. Radiology 2021;298(1):123–132. DOI: 10.1148/radiol.2020201791.

________________________
© The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.