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Vera Tiedje Department of Endocrinology, Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Martin Stuschke Department of Radiotherapy, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Frank Weber Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Henning Dralle Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Laura Moss Velindre Cancer Centre, Cardiff, Wales, UK

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Dagmar Führer Department of Endocrinology, Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Introduction Anaplastic thyroid carcinoma (ATC) is an orphan disease responsible for most thyroid carcinoma-associated deaths. Incidence is estimated to be 1–2 per million per year ( Smallridge et al . 2012 ). The histological diagnosis of

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Haleh Vosgha Cancer Molecular Pathology, School of Medicine, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia

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Armin Ariana Cancer Molecular Pathology, School of Medicine, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia

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Robert Anthony Smith Cancer Molecular Pathology, School of Medicine, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
Genomics Research Centre, Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia

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Alfred King-yin Lam Cancer Molecular Pathology, School of Medicine, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia

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Introduction Anaplastic thyroid carcinoma is one of the most aggressive and chemotherapy-resistant types of all thyroid carcinomas. The majority of patients with anaplastic thyroid carcinoma die within a year of diagnosis ( Lo et al . 1999

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Roberto Bellelli Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy
Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Maria Domenica Castellone Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy
Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Ginesa Garcia-Rostan Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Clara Ugolini Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Carmelo Nucera Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Peter M Sadow Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Tito Claudio Nappi Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy
Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Paolo Salerno Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy
Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Maria Carmela Cantisani Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy
Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Fulvio Basolo Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Tomas Alvarez Gago Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Giuliana Salvatore Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Massimo Santoro Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy
Dipartimento di Biologia e Patologia Cellulare e Molecolare, Istituto di Endocrinologia ed Oncologia Sperimentale ‘G. Salvatore’, Institute of Biology and Molecular Genetics, Department of Surgery, Human Thyroid Cancers Preclinical and Translational Research Program, Department of Pathology, Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, ‘L. Califano’, Universita' Federico II, Napoli, Italy

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Introduction Anaplastic thyroid carcinoma (ATC) is a rare tumor that accounts for 2–5% of all thyroid cancers. ATC ranks among the most lethal solid malignancies with a mean survival rate of 4–12 months after diagnosis. ATC usually presents between

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Alyaksandr V Nikitski Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Marina N Nikiforova Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Linwah Yip Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Esra Karslioglu-French Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Sally E Carty Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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Yuri E Nikiforov Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

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differentiated carcinoma (PDC); and (iii) anaplastic (undifferentiated) carcinoma (AC) ( Lloyd et al. 2017 ). Although the less differentiated cancers (PDC and AC) constitute less than 5% of all thyroid malignancies, they are the most lethal types of thyroid

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Carmela Passaro
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Antonella Abagnale
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Silvana Libertini Dipartimento di Biologia e Patologia Cellulare e Molecolare, The Beatson Institute for Cancer Research, Istituto di Biostrutture e Bioimmagini, Dipartimento di Diagnostica per Immagini e Radioterapia, Barts Cancer Institute, Facoltà di Medicina e Chirurgia, Università di Napoli Federico II, via S. Pansini 5, 80131 Napoli, Italy

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Massimiliano Volpe
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Ginevra Botta
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Laura Cella Dipartimento di Biologia e Patologia Cellulare e Molecolare, The Beatson Institute for Cancer Research, Istituto di Biostrutture e Bioimmagini, Dipartimento di Diagnostica per Immagini e Radioterapia, Barts Cancer Institute, Facoltà di Medicina e Chirurgia, Università di Napoli Federico II, via S. Pansini 5, 80131 Napoli, Italy

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Roberto Pacelli Dipartimento di Biologia e Patologia Cellulare e Molecolare, The Beatson Institute for Cancer Research, Istituto di Biostrutture e Bioimmagini, Dipartimento di Diagnostica per Immagini e Radioterapia, Barts Cancer Institute, Facoltà di Medicina e Chirurgia, Università di Napoli Federico II, via S. Pansini 5, 80131 Napoli, Italy

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Gunnel Halldèn Dipartimento di Biologia e Patologia Cellulare e Molecolare, The Beatson Institute for Cancer Research, Istituto di Biostrutture e Bioimmagini, Dipartimento di Diagnostica per Immagini e Radioterapia, Barts Cancer Institute, Facoltà di Medicina e Chirurgia, Università di Napoli Federico II, via S. Pansini 5, 80131 Napoli, Italy

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David Gillespie Dipartimento di Biologia e Patologia Cellulare e Molecolare, The Beatson Institute for Cancer Research, Istituto di Biostrutture e Bioimmagini, Dipartimento di Diagnostica per Immagini e Radioterapia, Barts Cancer Institute, Facoltà di Medicina e Chirurgia, Università di Napoli Federico II, via S. Pansini 5, 80131 Napoli, Italy

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Giuseppe Portella
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Introduction Anaplastic thyroid carcinoma (ATC) represents one of the most aggressive human malignancies. It arises from thyroid follicular cells showing morphological features of a malignant neoplasm, high proliferation rate, and marked aneuploidy

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Yeon-Sook Choi Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Hyemi Kwon Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

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Mi-Hyeon You Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Tae Yong Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Won Bae Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Young Kee Shong Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Min Ji Jeon Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Won Gu Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Introduction Anaplastic thyroid carcinoma (ATC) is a rare type of thyroid cancer with highly aggressive clinical features ( Kebebew et al. 2005 , Kurata et al. 2016 , Subbiah et al. 2018 , Lee & Park 2021 ). The median overall survival

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Enke Baldini Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Chiara Tuccilli Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Natalie Prinzi Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Salvatore Sorrenti Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Alessandro Antonelli Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Lucio Gnessi Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Stefania Morrone Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Costanzo Moretti Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Marco Bononi Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Yannick Arlot-Bonnemains Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Massimino D'Armiento Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Salvatore Ulisse Departments of Experimental Medicine, Surgical Sciences, Department of Internal Medicine, Department of Systems' Medicine, Department of Surgery ‘Pietro Valdoni’, CNRS – UMR 6290 (IGDR), ‘Sapienza’ University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy

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Introduction Anaplastic thyroid carcinoma (ATC) is a rare, highly aggressive form of thyroid cancer and overall one of the most deadly cancers, unresponsive to any available radio- and chemotherapy ( Smallridge et al . 2012 ). On presentation

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D Bonofiglio Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy
Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy

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H Qi Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy

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S Gabriele Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy

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S Catalano Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy
Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy

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S Aquila Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy
Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy

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M Belmonte Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy

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S Andò Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy
Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy
Department of Pharmaco-Biology, Centro Sanitario, Department of Cellular Biology, Faculty of Pharmacy, University of Calabria, 87036 Arcavacata di Rende (Cosenza), Italy

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decades ( Liu et al . 2001 ). More than 95% of thyroid carcinomas are derived from follicular epithelial cells, while a minority of tumors (2%) is referred as undifferentiated or anaplastic carcinoma, one of the most aggressive human malignancies ( Kondo

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Silvana Libertini
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Antonella Abagnale
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Carmela Passaro
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Ginevra Botta
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Sara Barbato
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Paolo Chieffi Dipartimento di Biologia e Patologia Cellulare e Molecolare, Dipartimento di Medicina Sperimentale, Facoltà di Medicina e Chirurgia, Università di Napoli Federico II, Via S. Pansini 5, 80131 Napoli, Italy

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Giuseppe Portella
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Introduction Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignancies, responsible for up to 40% of mortality from thyroid cancer. Although multimodality treatments are successfully applied for well-differentiated thyroid

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D Giuffrida Division of Medical Oncology, Ospedale San Luigi, Az. Osp. 'Garibaldi', Catania, Italy.

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H Gharib Division of Medical Oncology, Ospedale San Luigi, Az. Osp. 'Garibaldi', Catania, Italy.

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BACKGROUND

Clinically evident cardiac metastases from malignant neoplasms are uncommon. The frequency of thyroid metastasis to the heart is very low. To our knowledge, over the last 20 years only a few cases have been reported in the entire literature. Metastatic cardiac involvement occurs most often during the terminal stage.

PATIENTS

We present three cases of anaplastic thyroid cancer with metastatic involvement of the heart.

RESULTS

Two of the patients died from cardiac problems. The absence of early symptoms makes the clinical diagnosis of metastatic carcinoma difficult.

CONCLUSIONS

Anaplastic thyroid cancer is an aggressive cancer with a dismal prognosis. It should be borne in mind as a source of cardiac metastasis and a cause of cardiac death.

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