Liu Zichang, Yu Maosheng, Zhao Feng, Zhu Chenfang
Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Oncol. 2023 Mar 16;13:976415. doi: 10.3389/fonc.2023.976415. eCollection 2023.
Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare malignant tumor. The incidence rate of PSCCT is less than 1%. However, the diagnosis and treatment of PSCCT are limited. Surgical resection is considered to be one of the few effective intervention methods. In this article, we reported a case of taking tyrosine kinase inhibitors (TKIs) combined with immune checkpoint inhibitors (ICIs) for PSCCT.
An 80-year-old male was admitted to our hospital with dyspnea, cough, wheezing, and hoarseness for a giant thyroid mass. He underwent bronchoscopy and tracheal stent implantation to alleviate the respiratory obstruction. Then he accepted right partial thyroid and right lymph node biopsy. Postoperative pathology revealed squamous cell carcinoma. Subsequently, he underwent an endoscopy to exclude upper gastrointestinal squamous cell carcinoma. Finally, he was diagnosed with PSCCT. The patient was tentatively treated with a combination of Anlotinib and Sintilimab. After two courses, the tumor volume significantly reduced in MRI images and shrank further after five courses of combined treatment. Unfortunately, the patient died of fulminant liver failure and autoimmune liver disease after 5-month-treatment.
TKIs combined with ICIs may be an effective and novel way for PSCCT treatment, but immune-related complications, especially liver damage, should be cared.
甲状腺原发性鳞状细胞癌(PSCCT)是一种罕见的恶性肿瘤。PSCCT的发病率低于1%。然而,PSCCT的诊断和治疗方法有限。手术切除被认为是少数有效的干预方法之一。在本文中,我们报告了一例采用酪氨酸激酶抑制剂(TKIs)联合免疫检查点抑制剂(ICIs)治疗PSCCT的病例。
一名80岁男性因巨大甲状腺肿块导致呼吸困难、咳嗽、喘息和声音嘶哑入住我院。他接受了支气管镜检查和气管支架植入术以缓解呼吸道阻塞。随后,他接受了右半甲状腺及右淋巴结活检。术后病理显示为鳞状细胞癌。随后,他接受了内镜检查以排除上消化道鳞状细胞癌。最终,他被诊断为PSCCT。该患者接受了安罗替尼和信迪利单抗联合治疗。两个疗程后,MRI图像显示肿瘤体积显著缩小,联合治疗五个疗程后进一步缩小。不幸的是,患者在治疗5个月后死于暴发性肝衰竭和自身免疫性肝病。
TKIs联合ICIs可能是一种有效且新颖的PSCCT治疗方法,但应关注免疫相关并发症,尤其是肝损伤。