Abstract
BACKGROUND: Anaplastic thyroid cancer (ATC) is a rare, highly aggressive malignancy that accounts for less than 2% of thyroid cancers but contributes significantly to morbidity and mortality. Despite its rapid progression and poor prognosis, recent advances in targeted therapies and immunotherapies offer some hope for treatment. CASE PRESENTATION: A 55-year-old female with no prior thyroid disease was diagnosed with advanced ATC after a routine check-up revealed a neck mass. She presented with a tumor compressing the trachea, recurrent laryngeal nerve, and carotid sinus, accompanied by Horner's syndrome. Fine-needle aspiration confirmed anaplastic sarcoma. After a multidisciplinary consultation, the patient was treated with anlotinib, tislelizumab, and albumin-bound paclitaxel, resulting in significant tumor shrinkage and symptomatic relief. However, due to financial constraints, treatment was discontinued. One month later, the tumor rapidly progressed, leading to tracheal compression and asphyxiation, causing her death. CONCLUSION: This case highlights the potential benefits of combination therapy for advanced ATC, demonstrating significant temporary improvements. However, the discontinuation of treatment due to financial limitations led to rapid disease progression, underscoring the importance of continuous, accessible care. This case also emphasizes the impact of socio-economic factors on patient outcomes and survival in aggressive cancers.