Anaplastic Thyroid Carcinoma and Toxic Multinodular Goiter: A Case Report and Literature Review

Introduction: Anaplastic thyroid carcinoma (ATC) is a rare thyroid malignancy, comprising approximately 2% of all thyroid cancers, yet accounting for the majority of thyroid cancer-related deaths. ATC is characterized by aggressive behavior and rapid local invasion, leading to life-threatening complications such as airway compromise, dysphagia, and vascular encasement. Longstanding thyroid conditions such as multinodular goiter (MNG) may predispose to malignant transformation into ATC.

We report a case of ATC arising in a patient with a decade-long history of toxic MNG, underscoring the potential for severe complications even in seemingly stable thyroid disease.Case presentation: A 68-year-old female with a 10-year history of toxic MNG presented with neck swelling, dyspnea, and dysphagia. Laboratory findings showed suppressed thyroid-stimulating hormone and elevated free T4. Ultrasonography revealed nodules with macrocalcifications.

A total thyroidectomy was performed, and histopathological examination revealed ATC originating from one of the MNG nodules. Postoperatively, she received adjuvant chemoradiotherapy with carboplatin and doxorubicin. Initial imaging showed no metastasis, but after 10 months, a supraclavicular lymph node and posterior lung nodules indicated disease progression.

She developed pneumonia during treatment, leading to its discontinuation. Despite restarting therapy, her condition worsened, and she passed away eight months later.Literature review: A literature review identified six reported cases of ATC arising from MNG published between 2001 and 2020. The duration of MNG before malignant …