Anaplastic carcinoma of thyroid with distant metastasis or invasion into locally unresectable structures, such as the trachea or vasculatureof the anterior mediastinum, leads to a more conservative surgical approach, such as tracheostomy (palliation) as prognosis is very poor Postoperative external beam irradiation or adjunctive chemotherapy adds little to the overall prognosis but can be considered. note : question is treatment of choice, treatment of choice here is palliative care. Source : Sabiston 20th edition pg: 910