What is the role of surgery in Anaplastic Cancer of the Thyroid?

In the majority of cases surgery is limited to an open biopsy to exclude lymphoma (a tumour with a better prognosis than anaplastic cancer). Sometimes removal of the isthmus is necessary to free the windpipe from the tumour. Rarely the anaplastic tumour is confined within the thyroid, the patient has a normal voice and the trachea, carotid and oesophagus are not involved. In these rare circumstances an aggressive approach is justified and a total thyroidectomypossible, followed by chemoradiationIf speech or swallowing is affected by the tumour, total thyroidectomy is impossible and resection of the thyroid should not be considered.