Ma Dong-Xu, Ding Xiu-Ping, Zhang Chi, Shi Peng
Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China.
World J Clin Cases. 2022 Apr 26;10(12):3849-3855. doi: 10.12998/wjcc.v10.i12.3849.
Anaplastic thyroid carcinoma (ATC), also called undifferentiated thyroid cancer, is the least common but most aggressive and deadly thyroid gland malignancy of all thyroid cancers[1]. It has poor prognosis, and is the leading cause of death from malignant thyroid tumors. The one-year survival rate is 20%, with a median overall survival (OS) of only 5 mo[2]. The aim of this report is to provide our experience in the diagnosis and treatment of ATC.
A patient with a thyroid mass underwent surgical treatment after developing symptoms of hoarseness. The resected tumor was pathologically diagnosed as ATC. Imaging examination revealed organ and lymph node metastasis. After multiple cycles of chemotherapy and local radiotherapy, the metastases were not relieved and gradually increased in size and new metastases appeared. The patient immediately received immunotherapy combined with targeted therapy. During treatment, immune-related adverse reactions occurred, which were improved after symptomatic treatment, and tolerated by the patient. The OS of the patient was more than 30 mo after immunotherapy combined with targeted therapy.
For metastatic ATC, surgical treatment, radiotherapy and chemotherapy have no significant effect on remission of the disease. However, immunotherapy has made a breakthrough in the treatment of ATC.
间变性甲状腺癌(ATC),也称为未分化甲状腺癌,是所有甲状腺癌中最不常见但最具侵袭性和致命性的甲状腺恶性肿瘤[1]。其预后较差,是甲状腺恶性肿瘤致死的主要原因。一年生存率为20%,总生存期(OS)中位数仅为5个月[2]。本报告旨在分享我们在ATC诊断和治疗方面的经验。
一名甲状腺肿物患者在出现声音嘶哑症状后接受了手术治疗。切除的肿瘤经病理诊断为ATC。影像学检查显示有器官和淋巴结转移。经过多个周期的化疗和局部放疗后,转移灶未得到缓解,且逐渐增大并出现新的转移灶。患者随即接受了免疫治疗联合靶向治疗。治疗期间发生了免疫相关不良反应,经对症治疗后好转,患者能够耐受。免疫治疗联合靶向治疗后患者的OS超过了30个月。
对于转移性ATC,手术治疗、放疗和化疗对疾病缓解无显著效果。然而,免疫治疗在ATC治疗方面取得了突破。