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Anaplastic thyroid carcinoma diagnosed after treatment of lenvatinib for papillary thyroid carcinoma
- Source :
- Endocrinology, Diabetes & Metabolism Case Reports, Vol 1, Iss 1, Pp 1-5 (2019), Endocrinology, Diabetes & Metabolism Case Reports
- Publication Year :
- 2019
- Publisher :
- Bioscientifica, 2019.
-
Abstract
- Summary Anaplastic transformation of a primary thyroid tumor whose process can be followed is rare. The objective this study is to report a case of anaplastic transformation of locally advanced papillary thyroid carcinoma after treatment with lenvatinib. A 74-year-old woman consulted a local physician because of cough and bloody sputum. Thyroid cancer with tracheal invasion was suspected on computed tomography (CT) imaging, and she visited our hospital for treatment. We suspected anaplastic thyroid cancer (ATC) and core needle biopsy was performed. Histologic sections of the core needle biopsy showed that the tumor formed a papillary structure, and we diagnosed papillary thyroid carcinoma. Surgery would have been difficult, and we initiated lenvatinib at a low dose of 8 mg/day. CT on day 40 of lenvatinib treatment revealed that the thyroid tumor had shrunk remarkably. CT on day 111 revealed that tumor regrowth and tracheal invasion had been exacerbated. Core needle biopsy was performed, and histologic sections of the core needle biopsy that was performed after regrowth of the tumor showed that individual cancer cells had large, irregular nuclei, and necrosis was also observed. The immunohistochemical findings were negative for thyroglobulin, and only a few cells were positive for thyroid transcription factor 1, and we diagnosed ATC. Anaplastic transformation of the target lesion may be one of the causes of lenvatinib treatment failure in differentiated thyroid carcinoma. Learning points: Anaplastic transformation of a primary thyroid tumor whose process can be followed is rare. The resistance mechanism of lenvatinib in treatment for differentiated thyroid carcinoma has not been clarified. Anaplastic transformation of the target lesion may be one of the causes of lenvatinib treatment failure in differentiated thyroid carcinoma.
- Subjects :
- endocrine system
Pathology
medicine.medical_specialty
endocrine system diseases
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
030209 endocrinology & metabolism
lcsh:Diseases of the endocrine glands. Clinical endocrinology
Papillary thyroid cancer
Thyroid carcinoma
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Biopsy
Internal Medicine
Medicine
Anaplastic thyroid cancer
Thyroid cancer
lcsh:RC648-665
medicine.diagnostic_test
business.industry
Thyroid
Unique/Unexpected Symptoms or Presentations of a Disease
medicine.disease
medicine.anatomical_structure
chemistry
030220 oncology & carcinogenesis
Thyroglobulin
business
Lenvatinib
Subjects
Details
- ISSN :
- 20520573
- Volume :
- 2019
- Database :
- OpenAIRE
- Journal :
- Endocrinology, Diabetes & Metabolism Case Reports
- Accession number :
- edsair.doi.dedup.....05fe07e49bcd5e52b3e392b1ba453ec1
- Full Text :
- https://doi.org/10.1530/edm-19-0085