Anaplastichesky cancer of a thyroid gland
Anaplastichesky cancer of a thyroid gland – the rare, hard proceeding undifferentiated malignant tireoidny tumor. It is shown by pains, a dysphagy, breath difficulty, change of a voice, cough, a blood spitting, fever, loss of weight, increase in a thyroid gland and regionarny lymph nodes. Sudden rapid growth, germination of nearby bodies and bystry metastasis are characteristic. The diagnosis is exposed on the basis of complaints, anamnestichesky yielded, results of survey, KT, MPT and a cytologic research. Treatment – chemotherapy, radiation therapy. At local tumors operations are possible. The forecast is adverse.
Anaplastichesky cancer of a thyroid gland
Anaplastichesky cancer of a thyroid gland – the rare oncological disease which is usually developing against the background of the high-differentiated malignant tumors, good-quality new growths or a nodal craw. According to various data makes from 0,5% to 5% of total number of crayfish of a thyroid gland. Usually arises at advanced age, at young people comes to light seldom. The peak of incidence is the share of age of 65 years. One scientists believe that anaplastichesky cancer of a thyroid gland equally often occurs at women and at men, others note prevalence of female patients. This form of cancer is considered one of the most aggressive solid tumors. Metastatic damage of lymph nodes or the remote bodies is found in 40% of patients at the first address. The forecast is adverse, average life expectancy makes less than 1 year. Treatment is performed by experts in the sphere of oncology and endocrinology.
Reasons of anaplastichesky cancer of thyroid gland
As the main reason for development of this disease consider kataplastichesky processes as a result of which the high-differentiated cages in the course of reproduction undergo the return development and assimilate to the low-differentiated forms. During a kataplaziya all main characteristics of cages change: the size, structure, a set of chromosomes, biochemical and physical and chemical properties, and also functional features except for reproduction function.
Usually anaplastichesky cancer of a thyroid gland develops not from normal, and from already changed fabric of body. The good-quality new growth or the high-differentiated cancer (including – in several months or years after radical treatment) can become a source of an undifferentiated tumor. Many experts note previous long (within decades) existence of a nodal craw. Among the factors promoting development of a disease call ionizing radiation, contact with cancerogenic substances and immune violations.
There are several classifications of anaplastichesky cancer of thyroid gland made taking into account features of a morphological structure of a new growth. Larin and Khmelnytsky allocate 3 types of such tumors: gigantokletochny, veretenokletochny and skvamoidny (planocellular), also pointing to often found combination of intermediate and transitional forms. Skvamoidny anaplastichesky crayfish of a thyroid gland represent the new growths similar to neorogovevayushchy planocellular cancer, spindle-shaped contain a large number of spindle-shaped cages, gigantokletochny – a large number of huge cages.
At the same time at a research of samples of fabric of all types of anaplastichesky cancer of thyroid gland polymorphism, an atipizm and a large number of mitoses come to light. The cages characteristic of this or that type of a tumor alternate with cages of rounded or irregular shape. Both large, and small cages meet. Sometimes in a sample it is possible to allocate sites of the high-differentiated cages, on a structure a similar follicular or papillary carcinoma that demonstrates transformation of one type of cancer in another. Along with the listed types of anaplastichesky cancer, scientists describe others, the found new growth options are more rare, including – low-cellular, osteoklastichesky, kartsinosarkomatozny, limfoepiteliomopodobny cancer etc.
Symptoms of anaplastichesky cancer of thyroid gland
Usually patients see a doctor concerning quickly growing opukholevidny education in a neck. The average period of time between emergence of symptoms and the first visit to the expert fluctuates from 1 to 3 months. Three quarters of patients note unpleasant feelings when swallowing. At a half of patients pains at a palpation come to light or the irradiating pains. The osiplost of a voice and difficulty of breath are less often noted. At the time of the first address damage of regionarny lymph nodes and the remote bodies is found in 40% of patients with anaplastichesky cancer of a thyroid gland, including – lungs (50% of total of cases of metastasis), bones (15%) and a brain (10%).
At a palpation dense, hilly, motionless opukholevidny education is defined. Damage of skin with formation of sites of hyperaemia and ulcerations is possible. Sometimes in the field of anaplastichesky cancer of a thyroid gland sites of a softening come to light. In the presence of regionarny metastasises lymph nodes are increased, form motionless conglomerates. In the course of tumoral growth merge of primary tumor and the affected lymph nodes in the uniform conglomerate taking all forward surface of a neck is possible.
The rapid aggressive growth with damage of muscles, a gullet, trachea, throat and guttural nerve which is followed by the cough, a blood spitting expressed by difficulties at breath and meal is characteristic of anaplastichesky cancer of a thyroid gland. In some cases the new growth extends below jugular cutting and partially settles down behind a breast, striking bodies of a sredosteniye. Experts note that not the remote metastasises, but germination of vitals primary tumor become a cause of death of a significant amount of patients.
Rapid growth of anaplastichesky cancer of thyroid gland is followed by emergence of sites of a necrosis both in the field of oncological defeat, and in normal fabric of body. A large number of a tiroksin gets to the blood course that causes emergence of symptoms of a gipertireoz. Along with tiroksiny in blood the toxic products of disintegration provoking fever, weakness, anemia, a hyperthermia and other displays of cancer intoxication are soaked up. The condition of the patient is in addition aggravated with the violation of functions of various bodies which resulted from their metastatic defeat.
Diagnosis of anaplastichesky cancer of thyroid gland
The diagnosis is established taking into account the anamnesis, clinical symptomatology and these additional researches. The plan of inspection of patients with suspicion of anaplastichesky cancer of a thyroid gland includes ultrasonography of a thyroid gland, a X-ray analysis of a neck, KT of a thyroid gland, a laringoskopiya, a bronkhoskopiya and gastroscopy. When holding diagnostic procedures estimate prevalence of oncological process, the nature of defeat, degree of a sdavleniye of a gullet and trachea. For identification of the remote metastasises appoint a thorax X-ray analysis, a stsintigrafiya of bones of a skeleton, KT of a brain and other researches.
The final diagnosis of anaplastichesky cancer of thyroid gland is exposed on the basis of data of a cytologic research of the punktat received when carrying out a tonkoigolny punktsionny biopsy of a thyroid gland. Reliability of a research makes 80%, in other 20% of cases undifferentiated cages do not manage to be revealed, statement of the final diagnosis is carried out taking into account results of a histologic research of a remote new growth. The differential diagnosis is carried out with medullary cancer, high-malignant lymphoma, metastatic tumors and other new growths with similar structure.
Treatment and the forecast at anaplastichesky cancer of a thyroid gland
Effective methods of treatment of this pathology are not found yet. Radical removal of a tumor in most cases is impossible, surgical interventions have palliative character and are carried out with the diagnostic purpose or for reduction of expressiveness of the symptoms caused by a sdavleniye of nearby bodies. The most widespread tactics is the combined therapy including external radiation and reception of himiopreparat at local tumors – in combination with removal of a thyroid gland.
The forecast is extremely adverse. According to various data, average life expectancy of patients with anaplastichesky cancer of a thyroid gland does not exceed 6-9 months. Asphyxia owing to the aggressive growth of a tumor or bleeding from the breaking-up new growth becomes the reason of a lethal outcome usually. One year from the moment of diagnosis is possible to live 20-35% of patients. Five-year survival makes 5-10%.