Ashraf Shoaib, Shah Niel, Saad Muhammad, Jyala Abhilasha, Vittorio Timothy J
Internal Medicine, BronxCare Health System/Icahn School of Medicine at Mount Sinai, New York City, USA.
Cardiology, BronxCare Health System/Icahn School of Medicine at Mount Sinai, New York City, USA.
Cureus. 2022 Apr 28;14(4):e24556. doi: 10.7759/cureus.24556. eCollection 2022 Apr.
Medullary thyroid cancer (MTC) is a neuroendocrine tumor of the parafollicular cells of the thyroid gland. The prognosis is very poor in patients with advanced MTC. Vandetanib was approved for advanced MTC after randomized control trials showed that it had therapeutic efficacy and considerably prolonged progression-free survival. Vandetanib therapy is associated with serious cardiovascular side effects including hypertensive crisis and arrhythmias due to prolonged QTc. We present a case of an 83-year-old female with advanced metastatic MTC who is under treatment with vandetanib 300 mg/day and developed medication-related hyponatremia, QTc prolongation, ventricular fibrillation (VF), and torsades de pointes (TdP). Her vandetanib therapy was held. Subsequently, she did not show recurrences of TdP. This is the second such case report in the literature.
甲状腺髓样癌（MTC）是一种起源于甲状腺滤泡旁细胞的神经内分泌肿瘤。晚期MTC患者的预后非常差。在随机对照试验表明凡德他尼具有治疗效果并显著延长无进展生存期后，其被批准用于晚期MTC的治疗。凡德他尼治疗与严重的心血管副作用相关，包括因QTc延长导致的高血压危象和心律失常。我们报告一例83岁晚期转移性MTC女性患者，她正在接受每日300毫克凡德他尼治疗，并出现了与药物相关的低钠血症、QTc延长、心室颤动（VF）和尖端扭转型室性心动过速（TdP）。她的凡德他尼治疗被暂停。随后，她未再出现TdP复发。这是文献中第二例此类病例报告。
