Cytological diagnosis of rare variant of anaplastic thyroid carcinoma: case report

Abstract

Anaplastic thyroid carcinoma (ATC) is an exceptionally rare and highly aggressive malignancy, accounting for merely 1-2% of all thyroid cancers (TC). Despite its low incidence, ATC is notorious for its fulminant clinical course and dismal prognosis. Among the histological subtypes of ATC, the osteoclastic variant represents an exceedingly rare morphologic entity. It is characterized by the presence of numerous multinucleated osteoclast-like giant cells interspersed within the undifferentiated malignant component, raising diagnostic challenges and often necessitating thorough histopathological evaluation for confirmation. The advent and widespread utilization of fine-needle aspiration cytology (FNAC) has markedly transformed the diagnostic landscape of thyroid nodules. FNAC allows for early identification of undifferentiated and aggressive neoplastic processes, facilitating prompt clinical decision-making. Herein, we present a case of ATC with osteoclast-like giant cells in an elderly female patient. The diagnosis was initially suggested by cytological features observed on FNAC and subsequently confirmed on histopathological examination of the resected specimen. This case underscores the critical role of cytopathology in the early recognition of rare ATC variants and highlights the need for heightened clinical suspicion in rapidly evolving thyroid masses.