A rare expediting killer-primary thyroid gland sarcoma

Abstract

Primary thyroid malignancies can be classified into differentiated type (follicular, papillary, medullary, and anaplastic) and un-differentiated type or non-epithelial malignancies, particularly lymphomas and sarcomas. The reported frequency of primary thyroid sarcoma (PTS) cases ranges from 0.01% to 1.5%. Based on this fact, we present a case report of rare primary thyroid sarcoma (PTS) in Hospital Sibu, Sarawak. Our patient is a 78-year-old lady with multiple co-morbidities and her clinical deterioration is so rapid that its progression mimics thyroid anaplastic carcinoma which is commonly seen in female elderly as well. To diagnose such uncommon thyroid malignancy, the histopathology of the tumour needs to be conducted with immunohistochemical staining. Radiographic imaging such as computed tomography or magnetic resonance imaging of whole body is required for staging purpose and to look for metastasis. We analyze the clinical presentations of PTS and discuss its treatment and prognosis. The treatment of PTS must be assessed individually on case-by-case basis as currently there is no general consensus on treating this cancer.