Anaplastic thyroid carcinoma can arise from preexisting differentiated carcinoma and generally show dire prognosis. It usually occurs in the intrathyroid or regional lymph node, but can be developed in the metastatic site rarely. We report a case of a...
Anaplastic thyroid carcinoma can arise from preexisting differentiated carcinoma and generally show dire prognosis. It usually occurs in the intrathyroid or regional lymph node, but can be developed in the metastatic site rarely. We report a case of an 69-year old man who, 7 months after being treated with total thyroidectomy and I-131 therapy for papillary thyroid carcinoma, presented with anaplastic transformation in pleural metastatic site. Another interesting point in our case is patient showed an high white blood cell count. We performed him bone marrow biopsy for evaluating the cause of leukocytosis. But, there was no bone marrow involvement of malignant cells and no evidence of hematologic malignancy. Based on elevated serum granulocyte colony-stimulating factor (G-CSF) levels, it maybe due to paraneoplastic leukocytosis. And his WBC count decreased temporarily after systemic chemotherapy. Considering his clinical course, I-131 therapy maybe accelerate to anaplastic transformation. Clinicians, who treat well differentiated thyroid carcinoma, should be aware of the possibility of anaplastic transformation and should keep in mind that leukocytosis can be a initial sign of that change.