Dujovne Noelia, Lucero María B, Gazek Natalia, Pitoia Fabián, Felipe Laura, Ayarzabal Víctor, López Marti Jessica, Ciaccio Marta, Herzovich Viviana
Servicio de Endocrinología, Hospital J. P. Garrahan.
Servicio de Neumonología, Hospital J. P. Garrahan.
Arch Argent Pediatr. 2021 Feb;119(1):e70-e74. doi: 10.5546/aap.2021.e70.
Papillary thyroid cancer is the most common thyroid tumor in childhood. In advanced stages, it can present with respiratory failure. The treatment of choice is total thyroidectomy and radioactive iodine. In cases of unresectable tumors, therapy with multikinase inhibitors should be considered. A 10-year-old girl was referred for progressive respiratory failure. A diagnosis of papillary thyroid cancer with pulmonary metastases was made. Due to the presence of an unresectable tumor not subject to surgery, the compassionate use of lenvatinib was indicated, showing a rapid and favorable clinical response with resolution of respiratory failure on the ninth day. Early diagnosis of papillary thyroid cancer prevents severe respiratory morbidity caused by late diagnoses. The use of lenvatinib should be considered as a previous step towards first-line therapies (surgery and radioactive iodine) in cases with great local and distant involvement.
乳头状甲状腺癌是儿童期最常见的甲状腺肿瘤。在晚期，它可表现为呼吸衰竭。首选治疗方法是全甲状腺切除术和放射性碘治疗。对于无法切除的肿瘤病例，应考虑使用多激酶抑制剂进行治疗。一名10岁女孩因进行性呼吸衰竭前来就诊。诊断为伴有肺转移的乳头状甲状腺癌。由于存在无法手术切除的肿瘤，因此建议同情使用乐伐替尼，结果显示临床反应迅速且良好，在第9天呼吸衰竭得到缓解。乳头状甲状腺癌的早期诊断可预防因诊断延迟导致的严重呼吸并发症。在局部和远处受累严重的病例中，应考虑将乐伐替尼的使用作为一线治疗（手术和放射性碘）的前期步骤。
