A Rare Case of Retrosternal Anaplastic Thyroid Carcinoma

Anaplastic thyroid carcinoma (ATC) with retrosternal extension is a very uncommon and extremely aggressive malignancy with an exceptionally poor prognosis. This cancer usually infiltrates the surrounding anatomic structures as well as metastasizes into the neck or upper mediastinal lymph nodes. Multimodal treatment including surgery, chemo-radiotherapy, and targeted and immunotherapies serves for the cure, ameliorates the symptoms, or prolongs the survival. Radical surgery remains the most effective treatment modality, but unfortunately, it is not always applicable. Neoadjuvant therapies may render the tumor into an operable one and give a real chance for healing. In this article, we report a case of a 75-year-old man with loco-regional advanced anaplastic (undifferentiated) high-grade thyroid carcinoma mixed with papillary carcinoma. It was performed a cervicotomy, proximal partial median sternotomy, total thyroidectomy, partial resection of the right prethyroid and sternocleidomastoid muscles, medial part of the right clavicle, upper right corner of manubrium, right sternoclavicular joint, right internal jugular vein, right vagal and phrenic nerves, partial resection of the right subclavian vein, and patch plasty of the latter with pericardium, pericardial fenestration. The patient was referred to adjuvant radiotherapy.