Anaplastic thyroid cancer

Anaplastic thyroid cancer is an invasive type of thyroid cancer that grows very rapidly. It occurs most often in people over age 60. It is more common in females than in males. The cause is unknown.

Anaplastic cancer accounts for less than 1% to 2% of all thyroid cancers in the United States.

Symptoms include:

• Cough
• Coughing up blood
• Difficulty swallowing
• Hoarseness or changing voice
• Loud breathing
• Lower neck lump, which often grows quickly
• Pain in the neck
• Vocal cord paralysis
• Overactive thyroid (hyperthyroidism)

A physical exam almost always shows a growth in the neck region. Other exams may include:

• An MRI or CT scan of the neck may show a tumor growing from the thyroid gland.
• A thyroid biopsy makes the diagnosis. The tumor tissue can be checked for genetic markers that may suggest targets for treatment, preferably within a clinical trial.
• An examination of the airway with a fiberoptic scope (laryngoscopy) may show a paralyzed vocal cord.
• A thyroid scan shows this growth to be "cold," meaning it does not absorb a radioactive substance.

Thyroid function blood tests are normal in most cases.

This type of cancer cannot be cured by surgery.

Surgery combined with radiation therapy and chemotherapy may have a significant benefit.

Surgery to place a tube in the throat to help with breathing (tracheostomy) or in the stomach to help with eating (gastrostomy) may be needed during treatment.

For some people, enrolling in a clinical trial of new thyroid cancer treatments based on the genetic changes in the tumor may be an option.

The presence of a mutation in the BRAF gene is treatable with targeted medicines and may improve outcomes.

You can often ease the stress of illness by joining a support group of people sharing common experiences and problems.

The outlook with this disease is poor. Most people do not survive longer than 6 months because the disease is aggressive and there is a lack of effective treatment options. However modern targeted therapies particularly targeting BRAF variants has shown promise as well as the use of immunotherapy and other novel treatments.

Complications may include:

• Spread of tumor within the neck
• Metastasis (spread) of cancer to other body tissues or organs

Contact your health care provider if you notice:

• A persistent lump or mass in the neck
• Hoarseness or changes in your voice
• Cough or coughing up blood

Anaplastic carcinoma of the thyroid

Asban A, Patel AJ, Reddy S, Wang T, Balentine CJ, Chen H. Cancer of the endocrine system. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 68.

Bible KC, Kebebew E, Brierley J, et al. 2021 American Thyroid Association guidelines for management of patients with anaplastic thyroid cancer. Thyroid. 2021;31(3):337-386. PMID: 33728999 pubmed.ncbi.nlm.nih.gov/33728999/.

National Cancer Institute website. Thyroid cancer treatment (PDQ) - health professional version. www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq. Updated May 9, 2025. Accessed March 31, 2026.

National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): thyroid carcinoma. Version 1.2025. www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf. Updated March 27, 2025. Accessed March 31, 2026.

Pearce EN, Hollenberg AN. Thyroid. In: Goldman L, Cooney KA. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 207.

Updated by: Warren Brenner, MD, Oncologist, Lynn Cancer Institute, Boca Raton, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.