Huang Yuhao, Shen Qihuan, Lin Jiong, Zhou Hechao, Hu Wenhua, Zhang Zhi, Xu Zumin
Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
Department of Pathology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
Gland Surg. 2025 Jul 31;14(7):1399-1405. doi: 10.21037/gs-2025-88. Epub 2025 Jul 28.
Primary squamous cell carcinoma of the thyroid is a rare, highly lethal malignancy, comprising less than 1% of all thyroid cancers. It is associated with poor prognosis due to its rapid progression, resistance to conventional therapies, and frequent presentation at an advanced stage. The preferred treatment approach combines surgical resection with adjuvant radiotherapy or chemotherapy, yet outcomes remain unsatisfactory.
We report a case involving a 69-year-old female who presented with a progressively enlarging mass in the anterior neck. Computed tomography (CT) scans identified a right thyroid nodule measuring 4.0 cm × 4.7 cm × 5.3 cm. Subsequent fine needle aspiration biopsy confirmed thyroid squamous cell carcinoma, with molecular analysis revealing a positive BRAF (exon15:c.1801A>G:p.K601E) mutation. Given the substantial size of the neck mass and the unsuitability for surgical resection, neoadjuvant therapy was initiated. This included a combination of tislelizumab immunotherapy, chemotherapy, and anlotinib targeted therapy, which significantly reduced the size of tumor. The patient subsequently underwent a total thyroidectomy and remained disease-free for 2 years.
The present case demonstrates the potential of a multimodal treatment regimen encompassing chemotherapy, immunotherapy and targeted therapy, followed by surgical excision, for primary thyroid squamous cell carcinoma. Further studies are needed to validate the efficacy and safety of this combined treatment modality in larger patient populations.
原发性甲状腺鳞状细胞癌是一种罕见的、高度致命的恶性肿瘤，占所有甲状腺癌的比例不到1%。由于其进展迅速、对传统疗法耐药以及常处于晚期，其预后较差。首选的治疗方法是手术切除联合辅助放疗或化疗，但治疗效果仍不尽人意。
我们报告了一例69岁女性病例，该患者颈部前方出现逐渐增大的肿块。计算机断层扫描（CT）显示右侧甲状腺有一个大小为4.0 cm×4.7 cm×5.3 cm的结节。随后的细针穿刺活检确诊为甲状腺鳞状细胞癌，分子分析显示BRAF（外显子15：c.1801A>G：p.K601E）突变阳性。鉴于颈部肿块体积较大且不适合手术切除，遂开始新辅助治疗。治疗方案包括替雷利珠单抗免疫治疗、化疗和安罗替尼靶向治疗的联合应用，显著缩小了肿瘤大小。患者随后接受了全甲状腺切除术，术后无病生存2年。
本病例表明，对于原发性甲状腺鳞状细胞癌，采用包括化疗、免疫治疗和靶向治疗，随后进行手术切除的多模式治疗方案具有潜力。需要进一步研究以在更大规模的患者群体中验证这种联合治疗方式的疗效和安全性。
