Collins Dearbhaile Catherine, Yela Ruben, Horgan Noel, Power Derek Gerard
Department of Medical Oncology, Cork University Hospital, Wilton, Co. Cork, Ireland.
Department of Histopathology, Cork University Hospital, Wilton, Co. Cork, Ireland.
Case Rep Oncol Med. 2016;2016:6564094. doi: 10.1155/2016/6564094. Epub 2016 Mar 24.
Thyroid metastasis is a rare occurrence with cutaneous melanoma and even more uncommon with uveal melanoma. The management of such metastasis is uncertain due to its infrequency and, in the era of immunotherapy, the effect of these novel drugs on uncommon metastasis, such as to the thyroid, is unknown. We report the rare case of a thyroid metastasis in a patient diagnosed with ocular melanoma initially managed with enucleation. Metastatic disease developed in the lung and thyroid gland. The case patient received the immunotherapy ipilimumab with stable disease in the thyroid and progressive disease elsewhere. The patient was then further treated with a second immunotherapy agent, pembrolizumab, and remains with stable disease one year later. We discuss the current literature on thyroid metastases from all causes and the optimal known management strategies. Furthermore, we provide an original report on the response of this disease to the novel immunomodulators, ipilimumab, and pembrolizumab with stable disease four years after initial diagnosis of ocular melanoma.
甲状腺转移在皮肤黑色素瘤中较为罕见，在葡萄膜黑色素瘤中更是不常见。由于其罕见性，以及在免疫治疗时代，这些新药对诸如甲状腺等罕见转移灶的影响尚不清楚，此类转移的治疗方案尚无定论。我们报告了一例罕见的甲状腺转移病例，该患者最初诊断为眼黑色素瘤，接受了眼球摘除术。转移病灶出现在肺部和甲状腺。该病例患者接受了免疫治疗药物伊匹单抗，甲状腺病情稳定，其他部位病情进展。随后，患者接受了第二种免疫治疗药物帕博利珠单抗进一步治疗，一年后病情仍保持稳定。我们讨论了目前关于各种原因导致的甲状腺转移的文献以及已知的最佳治疗策略。此外，我们提供了一份原始报告，阐述了该疾病在眼黑色素瘤初诊四年后对新型免疫调节剂伊匹单抗和帕博利珠单抗的反应，病情保持稳定。
