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ATC with osteoclast-like giant cells (OGCs; ATC\/OGC) is a rare variant of ATC, and no detailed pathological examination has been reported to date. A 59-year-old woman presented with sudden neck swelling. Computed tomography revealed a 5\u00a0cm tumor in the thyroid gland, which was surgically resected. Pathological examination revealed a diagnosis of ATC\/OGC. The patient succumbed to progressive lung metastases within four months despite postoperative lenvatinib therapy. Immunohistochemical (IHC) examination indicated absence of PD-L1 expression in the OGCs, which comprised the majority of the tumor, with only sparse T cell infiltration in the area occupied by OGCs. Increased TGF-\u03b2 expression was observed in the area containing OGCs, and both OGCs and infiltrating myeloid cells, including CD1a\/CD11c-positive dendritic cells and CD68\/CD163\/CD204-positive macrophages, appeared to produce TGF-\u03b2. Pathological analysis of this case suggests that OGCs might be involved in immune suppression by secreting TGF-\u03b2, potentially serving as a critical cytokine in the immunosuppressive microenvironment of ATC\/OGC. TGF-\u03b2-targeted therapy might be useful in the treatment of this very rare subtype of ATC.<\/jats:p>","DOI":"10.1007\/s00795-025-00443-1","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T13:57:01Z","timestamp":1753365421000},"page":"64-70","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Anaplastic thyroid carcinoma with osteoclast-like giant cells: a case report and a study of a potential therapeutic approach"],"prefix":"10.1007","volume":"59","author":[{"given":"Kaori","family":"Yukino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9723-0846","authenticated-orcid":false,"given":"Yoshihiro","family":"Komohara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shukang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rin","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukio","family":"Fujiwara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Murakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Shimoda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruki","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yorihisa","family":"Orita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"443_CR1","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1089\/thy.2020.0944","volume":"31","author":"KC Bible","year":"2021","unstructured":"Bible KC, Kebebew E, Brierley J, Brito JP, Cabanillas ME, Clark TJ Jr, Di Cristofano A, Foote R, Giordano T, Kasperbauer J, Newbold K, Nikiforov YE, Randolph G, Rosenthal MS, Sawka AM, Shah M, Shaha A, Smallridge R, Wong Clark CK (2021) American thyroid association guidelines for management of patients with anaplastic thyroid cancer. 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