A Case of Anaplastic Thyroid Cancer that Became Resectable with Lenvatinib with Resultant Survival for Four Years

Abstract

DepartmentsofEndocrineandBreastSurgery 1) andDiagnosticPathology 2) ,OsakaPoliceHospital A60-year-oldwomanpresentedwithadiffusetumormainlyintherightlobeofthethyroidgland, involvingtherightinternaljugularveinandtrachealcartilageandmultiplepulmonarymetastases,which grewrapidly.Basedontheclinicalcourseandacytology,thecytologicalfindingsthediagnosisofundifferentiated carcinoma of the thyroid gland (suspected anaplastic carcinoma) was made (T4aEx2N1aM1 stageIVC).Sincetherewasariskofcausingoncologicalemergencyduetobilateralrecurrentnerveparalysis,lenvatinibwasstartedimmediately.Apartialresponse(PR)wasachievedwithin2weeksandthe patientwasmaintainedonlenvatinibfor2yearsand2months.Atthattime,thepatientunderwenttotal thyroidectomy without leaving gross residual tumor for local control. The pathological diagnosis was widelyinvasivefollicularcarcinomawithextensivescarringofthetumorotherthantheintravascularlesion. Lenvatinib was resumed following I -131 therapy and again a PR was maintained for 1 year and 4 months. We report a case of advanced thyroid cancer that was successfully treated with a multidisciplinaryapproach,withareviewoftheliterature.