Abstract
Anaplastic thyroid carcinoma (ATC) is a rare, highly aggressive thyroid malignancy that typically progresses rapidly and carries a poor prognosis. Diagnosis is often straightforward when a rapidly enlarging neck mass produces compressive symptoms, but optimal outcomes require urgent multidisciplinary care. We report a 60-year-old woman who presented with a 6-month history of a rapidly growing left anterior neck mass causing progressive hoarseness and dyspnea. Imaging demonstrated a bulky left thyroid lesion with marked tracheal compression, and ultrasound-guided fine needle aspiration cytology showed undifferentiated pleomorphic tumor cells consistent with ATC. After multidisciplinary review, she received neoadjuvant systemic chemotherapy to achieve cytoreduction, followed by near-total left thyroidectomy with excision of adherent soft tissue and tracheal decompression; adjuvant systemic therapy was completed postoperatively. Postoperative recovery was uncomplicated apart from transient dysphonia, and final histopathology confirmed ATC. She completed adjuvant systemic therapy and remains in clinical remission, defined by the absence of measurable disease on contrast-enhanced imaging and sustained clinical stability, 21 months after treatment initiation. While not generalisable, this case suggests that selected patients with locally advanced, nonmetastatic ATC may achieve sustained remission with coordinated multimodal therapy even in resource-limited settings without access to radiotherapy or targeted agents.