Kobayashi Tomoko, Iwama Shintaro, Suzuki Koji, Arima Hiroshi
Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
JCEM Case Rep. 2024 Jul 24;2(7):luae139. doi: 10.1210/jcemcr/luae139. eCollection 2024 Jul.
A 71-year-old woman was diagnosed with unresectable metastatic follicular thyroid carcinoma (FTC) and thyrotoxicosis. She was negative for the presence of thyroxine receptor antibody and thyroid-stimulating antibody. Whole-body scintigraphy revealed increased Tc-pertechnetate uptake in metastatic bone lesions but not in the thyroid nodule. Since radioactive iodine therapy was not applicable because the canalis vertebralis had been invaded, treatment with lenvatinib was initiated, along with methimazole and potassium iodide. The serum level of thyroid hormone decreased. The patient developed hypothyroidism, which continued after the methimazole was stopped, suggesting that lenvatinib suppressed the hyperthyroidism. To our best knowledge, this is the first report of a patient with functioning bone lesions of metastatic FTC in whom hyperthyroidism was controlled by lenvatinib without radioactive iodine therapy.
一名71岁女性被诊断为不可切除的转移性滤泡性甲状腺癌（FTC）并伴有甲状腺毒症。她的甲状腺素受体抗体和促甲状腺素抗体检测均为阴性。全身闪烁扫描显示，转移性骨病变部位的高锝酸盐摄取增加，而甲状腺结节部位未见增加。由于椎管已被侵犯，无法进行放射性碘治疗，遂开始使用乐伐替尼治疗，并联合使用甲巯咪唑和碘化钾。甲状腺激素血清水平下降。患者出现了甲状腺功能减退，在停用甲巯咪唑后仍持续存在，这表明乐伐替尼抑制了甲状腺功能亢进。据我们所知，这是首例转移性FTC功能性骨病变患者在未接受放射性碘治疗的情况下，其甲状腺功能亢进由乐伐替尼控制的报告。
