scholarly journals New Molecular Targeted Therapy and Redifferentiation Therapy for Radioiodine-Refractory Advanced Papillary Thyroid Carcinoma: Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Kai-Pun Wong ◽  
Brian Hung-Hin Lang
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Progressive Disease ◽  
Performance Status ◽  
New Drugs ◽  
Phase Iii ◽  
Treatment Modalities ◽  
Targeted Drugs ◽  
Papillary Thyroid ◽  
Radioiodine Ablation

Although the majority of papillary thyroid carcinoma could be successfully managed by complete surgical resection alone or resection followed by radioiodine ablation, a small proportion of patients may develop radioiodine-refractory progressive disease which is not amenable to surgery, local ablative treatment or other treatment modalities. The use of FDG-PET/CT scan for persistent/recurrent disease has improved the accuracy of restaging as well as cancer prognostication. Given that patients with RAI-refractory disease tend to do significantly worse than those with radioiodine-avid or non-progressive disease, an increasing number of phase I and II studies have been conducted to evaluate the efficacy of new molecular targeted drugs such as the tyrosine kinase inhibitors and redifferentiation drugs. The overall response rate of these drugs ranged between 0–53%, depending on whether the patients had been previously treated with these drugs, performance status and extent of disease. However, drug toxicity remains a major concern in administration of target therapies. Nevertheless, there are also ongoing phase III studies evaluating the efficacy of these new drugs. The aim of the review was to summarize and discuss the results of these targeted drugs and redifferentiation agents for patients with progressive, radioiodine-refractory papillary thyroid carcinoma.

scholarly journals ERADICATION OF PAPILLARY THYROID CARCINOMA IN A PATIENT RECEIVING PEMETREXED AND BEVACIZUMAB

2020 ◽  
Vol 6 (5) ◽  
pp. e247-e251
Author(s):  
John Dylan Pate ◽  
Christopher M. Gilbert ◽  
James T. Bonucchi
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Pet Scan ◽  
Treatment Modalities ◽  
Serous Carcinoma ◽  
Thyroid Function Tests ◽  
Papillary Thyroid ◽  
Recommended Treatment

Objective: To report a 66-year-old female patient whose medical management for advanced-stage, high-grade serous carcinoma of the ovary (HGSC-O) might have treated concomitant papillary thyroid carcinoma (PTC) diagnosed by fine-needle aspiration (FNA). Methods: Patient evaluation and management consisted of positron emission tomography (PET) scans, thyroid ultrasounds, FNA biopsies, and thyroid function tests. Results: The patient presented to the endocrinology clinic while undergoing treatment for HGSC-O with a PET scan revealing increased uptake in the thyroid gland. Due to the PET scan findings, she underwent a thyroid ultrasound examination which revealed co-existent multi-nodular goiter and a lesion with concerning features. FNA biopsy was read as PTC. Surgical intervention for PTC was delayed due to progression of the ovarian cancer. In the interim, she underwent chemotherapy with a regimen consisting of elesclomol, paclitaxel, pemetrexed (Alimta), carboplatin, gemcitabine (Gemazar), and bevacizumab (Avastin) at varying intervals. After the patient was able to complete near total thyroidectomy, surgical pathology revealed no viable malignancy. Conclusion: We postulate that the patient’s treatment for HGSC-O, namely pemetrexed (Alimta) and bevacizumab (Avastin), had antineoplastic effects against the PTC. These agents are not currently recommended treatment modalities for PTC. This hypothesis should be validated with further studies.

scholarly journals Pediatric papillary thyroid carcinoma successfully managed with a multimodal approach

2017 ◽  
Vol 6 (1) ◽  
pp. 372
Author(s):  
Rimesh Pal ◽  
Devi Dayal ◽  
Prema Menon ◽  
Balasubramaniyan Muthuvel ◽  
Soumya Devarapalli ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Patient Survival ◽  
Primary Treatment ◽  
Multimodal Approach ◽  
Papillary Thyroid ◽  
Malignant Tumours ◽  
Pediatric Age Group ◽  
Radioiodine Ablation ◽  
Time Of Presentation

Malignant tumours of the thyroid gland are rare in children. The tumours tend to be advanced at the time of presentation, but the overall survival is still better as compared to adults. The use of radioiodine ablation or treatment for the post-thyroidectomy gland remnants or recurrences improves patient survival. The reports of a multimodal approach that involves surgery as the primary treatment along with radioiodine ablation (RIA) are rare in the pediatric age group. We describe here a child with metastatic papillary thyroid carcinoma treated with a multimodal approach.

scholarly journals Rechallenge with Lenvatinib after Refractoriness to Initial Lenvatinib Followed by Sorafenib in a Patient with Metastatic Papillary Thyroid Carcinoma

2020 ◽  
Vol 13 (2) ◽  
pp. 522-527 ◽  
Author(s):  
Masaki Takinami ◽  
Tomoya Yokota
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Contrast Enhancement ◽  
Progressive Disease ◽  
Kinase Inhibitors ◽  
Lung Metastases ◽  
Treatment Options ◽  
Initial Response ◽  
Differentiated Thyroid Carcinoma ◽  
Papillary Thyroid

Two tyrosine kinase inhibitors, lenvatinib and sorafenib, are available systemic therapies for patients with metastatic differentiated thyroid carcinoma. However, the treatment options for carcinoma refractory to both lenvatinib and sorafenib are limited. Here, we present a case of metastatic papillary thyroid carcinoma that showed resensitization to rechallenge with lenvatinib. A 72-year-old woman who had been diagnosed with papillary thyroid carcinoma with multiple lymph node and lung metastases progressed with the emergence of subcutaneous metastasis after 3 years of response to initial lenvatinib. Five months after switching to sorafenib, the tumor was enlarged with increased contrast enhancement on computed tomography, suggesting progressive disease. Three months after the reintroduction of lenvatinib, marked tumor shrinkage and a decrease in its contrast enhancement were seen. Rechallenge with lenvatinib showed tumor resensitization. Therefore, rechallenge with lenvatinib may be a treatment option in patients who have experienced progressive disease after initial response to lenvatinib and subsequent sorafenib.

scholarly journals Papillary thyroid carcinoma presenting with cutaneous fungating mass complicated with myiasis: a case report

2015 ◽  
Vol 1 (2) ◽  
pp. 85
Author(s):  
Ningombam Jiten Singh ◽  
Sudhiranjan TH ◽  
Lailyang T ◽  
Anita N
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
English Literature ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Selective Neck Dissection ◽  
Papillary Thyroid ◽  
En Bloc ◽  
Ablation Therapy ◽  
Radioiodine Ablation

<p class="abstract">Papillary Thyroid Carcinoma (PTC) is the most common type of thyroid malignancy making upto 70-80% of all thyroid malignancies. PTC presenting with extrathyroidal cutaneous fungating mass is unusual. We report the management of a neglected fungating PTC which was complicated with myiasis. Such a case has not been reported earlier in the English literature. Preoperatively myiasis was managed conservatively following which she underwent total thyroidectomy with en-bloc resection of the fungating mass along with adequate skin margin and ipsilateral selective neck dissection. Postoperative period was uneventful and the patient was given radioiodine ablation therapy 4 weeks later.</p>

Clear Cell Variant of Papillary Thyroid Carcinoma With Associated Anaplastic Thyroid Carcinoma: Description of an Extraordinary Case

2019 ◽  
Vol 27 (6) ◽  
pp. 658-663
Author(s):  
Carl Christofer Juhlin ◽  
Anders Höög
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Clear Cell ◽  
Lung Metastases ◽  
Anaplastic Thyroid Carcinoma ◽  
Treatment Modalities ◽  
External Irradiation ◽  
Papillary Thyroid ◽  
Cell Variant ◽  
Clear Cell Variant

Clear cell change is a rare observation in thyroid cancer, resulting from aberrant cytoplasmic accumulation of lipids, glycogen, or thyroglobulin in the tumor cells. The phenomenon is most common for follicular thyroid neoplasia, with no definite coupling to patient outcome. The clear cell variant of papillary thyroid carcinoma (ccPTC) is even more infrequent—making conclusions regarding prognosis difficult. Single reports describe distant metastases of ccPTCs as well as co-occurrence with anaplastic thyroid carcinoma (ATC). In this report, a case of a therapy-resistant ccPTC dedifferentiating into an ATC is characterized from morphological and immunohistochemical standpoints. The patient was a 79-year-old female presenting with a 45-mm nodule in her right thyroid lobe. A first round of cytology raised the suspicion of PTC, but a repeated biopsy verified an ATC diagnosis. Neoadjuvant doxorubicin and external irradiation therapy was administered, and the patient developed lung metastases concomitantly. A palliative lobectomy was performed, and the final diagnosis was a ccPTC with focal dedifferentiation into an ATC. Intriguingly, the ccPTC component was viable and dominated the lesion. The clear cell morphology stemmed from an accumulation of glycogen, while the anaplastic component was devoid of evident clear cell changes. The case is one of exceedingly few descriptions of a ccPTC that dedifferentiates to an ATC, suggesting that this PTC subtype is not without potential for development of a highly lethal tumor component. Moreover, the partial lack of response to neoadjuvant therapy suggests a possible underlying resistance to aggressive treatment modalities in this particular case.

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