open access

Vol 61, No 5 (2010)
Case report
Published online: 2010-11-04
Submitted: 2013-02-15
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Treatment with sorafenib in advanced thyroid cancer - a case report

Jolanta Krajewska, Tomasz Olczyk, Józef Roskosz, Ewa Paliczk-Cieślik, Aleksandra Kukulska Anetta Śmietana, Bożenna Kaczmarek-Borowska, Barbara Jarząb
Endokrynologia Polska 2010;61(5):492-496.

open access

Vol 61, No 5 (2010)
Case report
Published online: 2010-11-04
Submitted: 2013-02-15

Abstract

Papillary thyroid cancer (PTC) usually has a good prognosis. The treatment, including total thyroidectomy and complementary radioiodine (RAI) therapy, gives complete remission in 90% of patients. However, in 10% of subjects with metastatic disease, the prognosis is poor. In the group of patients with disease progression and no 131I uptake, searching for new therapeutic modalities before all tyrosine kinase inhibitors and other antiangiogenic agents is necessary.
The study presents the case of a 55-year-old male with advanced PTC /pT3mNxMo/ diagnosed in 1993. Primary treatment by total thyroidectomy and 131I ablation led to complete remission. In 2000 local as well as lymph node recurrence was diagnosed and successively treated by surgery. In 2006 an increasing serum thyroglobulin level was noted and a single lung metastasis was diagnosed and operated on. In 2007 new foci in CNS and vertebral column with no 131I uptake were stated. Further progression (bones, CNS, and pterygoid muscle) was confirmed by PET-CT. The patient underwent neurosurgical metastasectomy twice and palliative CNS and vertebra’s radiotherapy. Liver metastases were diagnosed in 2009. Treatment with increasing doses of thalidomide (up to 800 mg/d) was administered for 3 months with a good tolerance; however, the therapy was withdrawn due to cancer progression. Next, sorafenib (800 mg/d) was given for 16 weeks. Radiological examination performed after 16 weeks confirmed stable disease, whereas 2 months later, after sorafenib withdrawal due to lack of treatment possibility, further progression was observed. Metronomic chemotherapy with Adriamycin was instituted which gave disease stabilization for 6 months. The patient died with advanced disseminated disease due to pulmonary embolism.
We present this case to document no adverse effects of therapy with sorafenib in a patient with brain DTC metastases. Sorafenib therapy was only short-term, but no progression occurred in this time.
(Pol J Endocrinol 2010; 61 (5): 492-496)

Abstract

Papillary thyroid cancer (PTC) usually has a good prognosis. The treatment, including total thyroidectomy and complementary radioiodine (RAI) therapy, gives complete remission in 90% of patients. However, in 10% of subjects with metastatic disease, the prognosis is poor. In the group of patients with disease progression and no 131I uptake, searching for new therapeutic modalities before all tyrosine kinase inhibitors and other antiangiogenic agents is necessary.
The study presents the case of a 55-year-old male with advanced PTC /pT3mNxMo/ diagnosed in 1993. Primary treatment by total thyroidectomy and 131I ablation led to complete remission. In 2000 local as well as lymph node recurrence was diagnosed and successively treated by surgery. In 2006 an increasing serum thyroglobulin level was noted and a single lung metastasis was diagnosed and operated on. In 2007 new foci in CNS and vertebral column with no 131I uptake were stated. Further progression (bones, CNS, and pterygoid muscle) was confirmed by PET-CT. The patient underwent neurosurgical metastasectomy twice and palliative CNS and vertebra’s radiotherapy. Liver metastases were diagnosed in 2009. Treatment with increasing doses of thalidomide (up to 800 mg/d) was administered for 3 months with a good tolerance; however, the therapy was withdrawn due to cancer progression. Next, sorafenib (800 mg/d) was given for 16 weeks. Radiological examination performed after 16 weeks confirmed stable disease, whereas 2 months later, after sorafenib withdrawal due to lack of treatment possibility, further progression was observed. Metronomic chemotherapy with Adriamycin was instituted which gave disease stabilization for 6 months. The patient died with advanced disseminated disease due to pulmonary embolism.
We present this case to document no adverse effects of therapy with sorafenib in a patient with brain DTC metastases. Sorafenib therapy was only short-term, but no progression occurred in this time.
(Pol J Endocrinol 2010; 61 (5): 492-496)
Get Citation

Keywords

differentiated thyroid cancer; sorafenib; radioiodine resistant

About this article
Title

Treatment with sorafenib in advanced thyroid cancer - a case report

Journal

Endokrynologia Polska

Issue

Vol 61, No 5 (2010)

Pages

492-496

Published online

2010-11-04

Bibliographic record

Endokrynologia Polska 2010;61(5):492-496.

Keywords

differentiated thyroid cancer
sorafenib
radioiodine resistant

Authors

Jolanta Krajewska
Tomasz Olczyk
Józef Roskosz
Ewa Paliczk-Cieślik
Aleksandra Kukulska Anetta Śmietana
Bożenna Kaczmarek-Borowska
Barbara Jarząb

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