Anaplastic Thyroid Carcinoma and High-Grade Tall Cell Papillary Thyroid Carcinoma: Case Report of a Rare Association
Abstract
1. Introduction and Clinical Significance
2. Case Presentation
2.1. Clinical History and Presentation
2.2. Laboratory Findings
2.3. Imaging Studies
2.4. Surgical Findings
2.5. Histopathological Findings
2.6. Immunohistochemical Findings
2.7. Clinical Outcome and Follow-Up
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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| Period/Classification | Entity | Key Histologic Criteria | Conceptual/Clinical Implications |
|---|---|---|---|
| 1970s—initial descriptions [9] | Tall cell variant of papillary thyroid carcinoma (PTC) | Tumor cells at least two–three times taller than they are wide; abundant eosinophilic cytoplasm; classic PTC nuclear features; no formal cut-off for proportion of tall cells | First recognition of tall cell morphology; aggressive behavior suspected, but nor formally graded |
| 1980s–1990s | Anaplastic thyroid carcinoma (ATC) | Marked cellular pleomorphism; spindle, epithelioid, or giant cells; frequent atypical mitoses; tumor necrosis; complete loss of follicular differentiation | ATC regarded primarily as a de novo undifferentiated carcinoma with uniformly poor prognosis |
| 1990s–early 2000s | Tall cell PTC | Variable diagnostic thresholds (30–50% tall cells); absence of standardized grading criteria; mitotic activity and necrosis often noted but not formally integrated | Increasing recognition of aggressive clinical course but persistent diagnostic heterogeneity |
| 2007—Turin Criteria proposal [22] | Poorly differentiated thyroid carcinoma (PDTC) | Solid, trabecular, or insular growth pattern plus ≥1 of mitotic activity ≥3/10 HPF, tumor necrosis, or convoluted nuclei | Introduced objective high-grade criteria, but excluded PTC with classic papillary architecture |
| 2017—WHO 4th edition [23] | Tall cell PTC | ≥30% tall cells with classic PTC nuclear features; no grading system for high-grade features within PTC | Tall cell PTC formally classified as an aggressive variant, but mitoses and necrosis not used for grading |
| 2017—WHO 4th edition [23] | ATC | Undifferentiated carcinoma showing spindle, giant, or epithelioid morphology; high mitotic rate; necrosis; invasive growth | Acknowledged that ATC may arise from differentiated carcinomas, but without formal intermediate category |
| 2022—WHO 5th edition [24] | Differentiated high-grade thyroid carcinoma (DHGTC), including tall cell PTC | Retained differentiated morphology with mitotic activity ≥5/2 mm2 and/or tumor necrosis, regardless of architectural pattern | Introduces objective histologic criteria for recognizing high-grade features within otherwise differentiated thyroid carcinomas, providing a standardized diagnostic framework |
| 2022—WHO 5th edition [24] | Tall cell PTC | ≥30% tall cells; three times taller than they are wide; classified as high-grade if mitosis and/or necrosis criteria are met | Allows objective identification of tall cell PTC with increased risk of aggressive behavior |
| 2022—WHO 5th edition [24] | ATC | Undifferentiated carcinoma, often arising in association with differentiated with/without high-grade component; marked mitoses, necrosis, invasion | Defines ATC as an undifferentiated malignancy that may occur in association with differentiated thyroid carcinomas, acknowledging potential relationships without establishing a defined progression sequence |
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Satala, C.-B.; Gurau, A.-M.; Patrichi, G.; Mihalache, D. Anaplastic Thyroid Carcinoma and High-Grade Tall Cell Papillary Thyroid Carcinoma: Case Report of a Rare Association. Reports 2026, 9, 56. https://doi.org/10.3390/reports9010056
Satala C-B, Gurau A-M, Patrichi G, Mihalache D. Anaplastic Thyroid Carcinoma and High-Grade Tall Cell Papillary Thyroid Carcinoma: Case Report of a Rare Association. Reports. 2026; 9(1):56. https://doi.org/10.3390/reports9010056
Chicago/Turabian StyleSatala, Catalin-Bogdan, Alina-Mihaela Gurau, Gabriela Patrichi, and Daniela Mihalache. 2026. "Anaplastic Thyroid Carcinoma and High-Grade Tall Cell Papillary Thyroid Carcinoma: Case Report of a Rare Association" Reports 9, no. 1: 56. https://doi.org/10.3390/reports9010056
APA StyleSatala, C.-B., Gurau, A.-M., Patrichi, G., & Mihalache, D. (2026). Anaplastic Thyroid Carcinoma and High-Grade Tall Cell Papillary Thyroid Carcinoma: Case Report of a Rare Association. Reports, 9(1), 56. https://doi.org/10.3390/reports9010056

