Cardiac metastasis from primary anaplastic thyroid carcinoma: report of three cases and a review of the literature.

2001 ◽  
pp. 71-73 ◽  
Author(s):  
D Giuffrida ◽  
H Gharib
Keyword(s):  
Thyroid Cancer ◽  
Anaplastic Thyroid Cancer ◽  
Metastatic Carcinoma ◽  
Anaplastic Thyroid Carcinoma ◽  
Cardiac Metastasis ◽  
Malignant Neoplasms ◽  
Dismal Prognosis ◽  
Aggressive Cancer ◽  
Cardiac Metastases ◽  
Metastatic Involvement

BACKGROUNDClinically evident cardiac metastases from malignant neoplasms are uncommon. The frequency of thyroid metastasis to the heart is very low. To our knowledge, over the last 20 years only a few cases have been reported in the entire literature. Metastatic cardiac involvement occurs most often during the terminal stage.PATIENTSWe present three cases of anaplastic thyroid cancer with metastatic involvement of the heart.RESULTSTwo of the patients died from cardiac problems. The absence of early symptoms makes the clinical diagnosis of metastatic carcinoma difficult.CONCLUSIONSAnaplastic thyroid cancer is an aggressive cancer with a dismal prognosis. It should be borne in mind as a source of cardiac metastasis and a cause of cardiac death.

Subclavian vein compression in anaplastic carcinoma of the thyroid

2002 ◽  
Vol 116 (6) ◽  
pp. 480-481
Author(s):  
S. I. Ibrahim ◽  
R. J. A. England ◽  
D. F. Ettles
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Subclavian Vein ◽  
Anaplastic Thyroid Cancer ◽  
Anaplastic Thyroid Carcinoma ◽  
Anaplastic Carcinoma ◽  
Carcinoma Of The Breast ◽  
Venous Stenting ◽  
Dismal Prognosis

Anaplastic thyroid cancer is a condition with a dismal prognosis in most cases. We present a case of subclavian vein compression in a case of anaplastic thyroid carcinoma treated with subclavian venous stenting. Subclavian vein compression is a recognized complication in disseminated carcinomatosis particularly in carcinoma of the breast and bronchus. It has never been described in anaplastic thyroid carcinoma.

scholarly journals Thyroid Carcinoma with Pituitary Metastases: 2 Case Reports and Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Weiying Lim ◽  
Dawn Shaoting Lim ◽  
Chiaw Ling Chng ◽  
Adoree Yiying Lim
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Radioiodine Therapy ◽  
Follicular Thyroid Carcinoma ◽  
Case Reports ◽  
Anaplastic Thyroid Cancer ◽  
Anaplastic Thyroid Carcinoma ◽  
Pituitary Metastases ◽  
History Of ◽  
Loss Of Appetite

We present 2 patients with pituitary metastases from thyroid carcinoma—the first from anaplastic thyroid carcinoma and the second from follicular thyroid carcinoma. The first patient, a 50-year-old lady, presented with 2-week history of hoarseness of voice, dysphagia, dyspnoea, and neck swelling. Imaging revealed metastatic thyroid cancer to lymph nodes and bone. Histology from surgery confirmed anaplastic thyroid cancer. She was found to have pituitary metastases postoperatively when she presented with nonvertiginous dizziness. She subsequently underwent radiotherapy and radioiodine treatment but passed away from complications. The second patient, a 65-year-old lady, presented with loss of appetite and weight with increased goitre size and dyspnoea. Surgery was performed in view of compressive symptoms and histology confirmed follicular thyroid carcinoma. Imaging revealed metastases to bone, lung, and pituitary. She also had panhypopituitarism with hyperprolactinemia and diabetes insipidus. She received radioiodine therapy but eventually passed away from complications.

scholarly journals Recent advances and emerging therapies in anaplastic thyroid carcinoma

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 87 ◽  
Author(s):  
Maria E. Cabanillas ◽  
Mark Zafereo ◽  
Michelle D. Williams ◽  
Renata Ferrarotto ◽  
Ramona Dadu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Poor Prognosis ◽  
Recent Progress ◽  
Anaplastic Thyroid Cancer ◽  
Anaplastic Thyroid Carcinoma ◽  
Novel Therapies ◽  
Emerging Therapies ◽  
Improved Outcomes

Anaplastic thyroid cancer is a rare and aggressive thyroid cancer with an overall survival measured in months. Because of this poor prognosis and often advanced age at presentation, these patients have traditionally been treated palliatively and referred for hospice. However, recent progress using novel therapies has energized the field, and several promising clinical trials are now available for these patients. This review will highlight this progress and the potential treatments that could pave the way to improved outcomes and quality of life for patients with this disease.

scholarly journals Novel role of ASH1L histone methyltransferase in anaplastic thyroid carcinoma

2020 ◽  
Vol 295 (26) ◽  
pp. 8834-8845 ◽  
Author(s):  
Bin Xu ◽  
Tingting Qin ◽  
Jingcheng Yu ◽  
Thomas J. Giordano ◽  
Maureen A. Sartor ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cell Lines ◽  
Noncoding Rna ◽  
Anaplastic Thyroid Cancer ◽  
Histone Methyltransferase ◽  
Anaplastic Thyroid Carcinoma ◽  
Average Life Expectancy ◽  
Upstream Regulator ◽  
Histone Lysine Methyltransferase ◽  
Lysine Methyltransferase

Anaplastic thyroid cancer (ATC) is one of the most aggressive human malignancies, with an average life expectancy of ∼6 months from the time of diagnosis. The genetic and epigenetic changes that underlie this malignancy are incompletely understood. We found that ASH1-like histone lysine methyltransferase (ASH1L) is overexpressed in ATC relative to the much less aggressive and more common differentiated thyroid cancer. This increased expression was due at least in part to reduced levels of microRNA-200b-3p (miR-200b-3p), which represses ASH1L expression, in ATC. Genetic knockout of ASH1L protein expression in ATC cell lines decreased cell growth both in culture and in mouse xenografts. RNA-Seq analysis of ASH1L knockout versus WT ATC cell lines revealed that ASH1L is involved in the regulation of numerous cancer-related genes and gene sets. The pro-oncogenic long noncoding RNA colon cancer-associated transcript 1 (CCAT1) was one of the most highly (approximately 68-fold) down-regulated transcripts in ASH1L knockout cells. Therefore, we investigated CCAT1 as a potential mediator of the growth-inducing activity of ASH1L. Supporting this hypothesis, CCAT1 knockdown in ATC cells decreased their growth rate, and ChIP-Seq data indicated that CCAT1 is likely a direct target of ASH1L's histone methyltransferase activity. These results indicate that ASH1L contributes to the aggressiveness of ATC and suggest that ASH1L, along with its upstream regulator miR-200b-3p and its downstream mediator CCAT1, represents a potential therapeutic target in ATC.

Multimodal therapeutic approach in anaplastic thyroid cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15533-15533 ◽  
Author(s):  
Y. Lee ◽  
J. Jung ◽  
G. Hwang ◽  
H. Park ◽  
Y. Im
Keyword(s):  
Thyroid Cancer ◽  
Distant Metastasis ◽  
Tumor Size ◽  
Survival Rates ◽  
Anaplastic Thyroid Cancer ◽  
Rank Test ◽  
Presenting Symptoms ◽  
Dismal Prognosis ◽  
Extrathyroidal Invasion ◽  
The Mean

15533 Background: Anaplastic thyroid cancer (ATC) is a rare but highly aggressive neoplasm with a dismal prognosis. However, a few patients survive for a long time after treatment. We tried to identify prognostic factors of this disease and analyzed treatment outcomes in patients with ATC. Methods: We reviewed the medical records of 15 patients diagnosed with ATC in our institution between 1988 and 2003. The survival was compared by the Kaplan-Meier log-rank test. Results: The female-to-male ratio was 1.5:1 (9 women and 6 men), and the mean age at diagnosis was 63.9 years (range, 44–91). The mean tumor size was 6.3cm (range, 4–10 cm). Extrathyroidal invasion was present in 12 cases and distant metastasis at diagnosis was present in 6 cases. Surgery was performed in 8 cases. Radiotherapy was used for 10 cases and chemotherapy for 5 cases. The mean overall survival time of the 15 patients was 237 days (range, 28–717 days). The 6-, 12-, 18- and 24-month survival rates were 33%, 26%, 13% and 0%. No association was found between survival and presenting symptoms, age, gender, tumor size, previous goiter history, extrathyroidal invasion, distant metastasis, surgery, radiotherapy or chemotherapy. A significantly better outcome was observed in patients received triple modality treatment (surgery, radiotherapy and chemotherapy) than in those received single or dual modality treatment (P = 0.05). Conclusions: Although most patients with ATC had a poor prognosis, a multimodal approach including surgery, radiotherapy and chemotherapy, might improve survival. No significant financial relationships to disclose.

scholarly journals Valproic acid, a histone deacetylase inhibitor, enhances sensitivity to doxorubicin in anaplastic thyroid cancer cells

2006 ◽  
Vol 191 (2) ◽  
pp. 465-472 ◽  
Author(s):  
Maria G Catalano ◽  
Nicoletta Fortunati ◽  
Mariateresa Pugliese ◽  
Roberta Poli ◽  
Ornella Bosco ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Thyroid Cancer ◽  
Histone Deacetylase ◽  
Topoisomerase Ii ◽  
Human Cancer ◽  
Combined Therapy ◽  
Survival Rates ◽  
Hdac Inhibitors ◽  
Anaplastic Thyroid Cancer ◽  
Anaplastic Thyroid Carcinoma

Multimodality treatments (i.e. surgery, chemotherapy, and radiotherapy) are recommended for anaplastic thyroid carcinoma (ATC), an extremely lethal human cancer, but to date there is little evidence that such approaches improve survival rates. It is thus necessary to seek new therapeutic tools. Histone deacetylase (HDAC) inhibitors are a promising class of anti-neoplastic agents that induce differentiation and apoptosis. Moreover, they may enhance the cytotoxicity of drugs targeting DNA through acetylation of histones. Using two ATC cell lines (CAL-62 and ARO), we show here that valproic acid (VPA), a clinically available HDAC inhibitor, enhances the activity of doxorubicin, whose anti-tumor properties involve binding to DNA and inhibiting topoisomerase II. A meager 0.7 mM VPA, which corresponds to serum concentrations in patients treated for epilepsy, is able to increase the cytotoxicity of doxorubicin about threefold in CAL-62 cells and twofold in ARO cells. The sensitizing effect, which is through histone acetylation, involves increased apoptosis, which is also shown by the increased caspase 3 activation and the enhancement of doxorubicin-induced G2 cell cycle arrest. These results might offer a rationale for clinical studies of a new combined therapy in an effort to improve the outcome of patients with anaplastic thyroid cancer.

scholarly journals Effect of Valproic Acid on miRNAs Affecting Histone Deacetylase in a Model of Anaplastic Thyroid Cancer

2021 ◽  
Author(s):  
Nur Selvi Günel ◽  
Nihal Birden ◽  
Cansu Çalışkan Kurt ◽  
Bakiye Göker Bağca ◽  
behrouz shademan ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Thyroid Cancer ◽  
Histone Deacetylase ◽  
Expression Patterns ◽  
Endocrine System ◽  
Anaplastic Thyroid Cancer ◽  
Anaplastic Thyroid Carcinoma ◽  
Rt Pcr ◽  
Surgical Interventions ◽  
Genes Expression

Abstract Thyroid cancer is the most common malignant tumor of the endocrine system seen in the thyroid gland. More than 90% of thyroid cancers comprise papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC). Although anaplastic thyroid carcinoma (ATC) accounts for less than 2% of thyroid cancer. But patients' lifespan after diagnosis is about 6 months. Surgical interventions, radioactive iodine use, and chemotherapy are not sufficient in the treatment of ATC, so alternative therapies are needed. The WST-1 assay test was performed to evaluate the anti-proliferative effects of Valproic acid (VPA). Also, Effect of VPA on miRNAs affecting histone deacetylase were determined by Quantitative RT-PCR. In BRAFV600E / mut SW1736 (SW1736) cell line IC50 dose for VPA found 1.6 mg/ml. in our study, the level of oncogenic genes expression in cells treated with VPA, including miR-184, miR-222-5p, miR-124-3p, and miR-328-3p, decreased. Also, the expression of tumor inhibitory genes is miR-323-5p, miR-182-5p, miR-138-5p, miR-217, miR-15a-5p, miR-29b-3p, miR-324-5p and miR-101- 5p increased significantly. VPA can ad-just countless gene expression patterns, including microRNAs (miRNAs), by targeting histone deacetylase (HDAC). We got very promising results with VPA.

scholarly journals New-onset thyrotoxicosis in a patient with anaplastic thyroid carcinoma: a diagnostic challenge

2021 ◽  
Vol 2021 ◽  
Author(s):  
Marcio José Concepción Zavaleta ◽  
Sofia Pilar Ildefonso Najarro ◽  
Esteban Alberto Plasencia Dueñas ◽  
María Alejandra Quispe Flores ◽  
Diego Martín Moreno Marreros ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Anaplastic Thyroid Cancer ◽  
Thyroid Stimulating Hormone ◽  
Anaplastic Thyroid Carcinoma ◽  
List Type ◽  
Diagnostic Challenge ◽  
Adequate Treatment ◽  
The Right

Summary Anaplastic thyroid cancer (ATC) is the type of thyroid cancer that has the worst prognosis. It usually presents as a rapidly growing cervical mass that generates compressive symptoms. Its association with thyrotoxicosis is rare. A 76-year-old woman, with no contributory history, presented with a 3-month course of fast-growing cervical tumor, associated with tenderness, cough, and weight loss. Physical examination revealed goiter, localized erythema, and a painful and stone tumor dependent on the right thyroid lobe. Due to the malignant findings of the thyroid ultrasound, the patient underwent a thyroid core needle biopsy, which indicated ATC. Laboratory tests revealed leukocytosis, decreased thyroid-stimulating hormone, elevated free thyroxine (fT4), and increased thyroperoxidase (TPO) antibodies. At the beginning, we considered that the etiology of thyrotoxicosis was secondary to subacute thyroiditis (SAT) after SARS-CoV-2 infection, due to the immunochromatography result and chest tomography findings. The result of markedly elevated TPO antibodies left this etiology more remote. Therefore, we suspected Graves’ disease as an etiology; however, thyroid histopathology and ultrasound did not show compatible findings. Therefore, we suspect that the main etiology of thyrotoxicosis in the patient was the destruction of the thyroid follicles caused by a rapid invasion of malignant cells, which is responsible for the consequent release of preformed thyroid hormone. ATC is a rare endocrine neoplasm with high mortality; it may be associated with thyrotoxicosis, whose etiology can be varied; therefore, differential diagnosis is important for proper management. Learning points Anaplastic thyroid cancer is the thyroid cancer with the worst prognosis and the highest mortality. The association of anaplastic thyroid cancer with thyrotoxicosis is rare, and a differential diagnosis is necessary to provide adequate treatment. Due to the current pandemic, in patients with thyrotoxicosis, it is important to rule out SARS-CoV-2 as an etiology. Anaplastic thyroid cancer, due to its aggressive behavior and rapid growth, can destroy thyroid follicular cells, generating preformed thyroid hormone release, being responsible for thyrotoxicosis.

204 The role of immune checkpoint inhibitor as a single agent or combination therapy in advanced thyroid cancer

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A219-A220
Author(s):  
Ju Young Lee ◽  
Inae Park ◽  
Myungwoo Nam ◽  
Christmann Low ◽  
Eugene Kim ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Combination Therapy ◽  
Thyroid Carcinoma ◽  
Clinical Oncology ◽  
Differentiated Thyroid Cancer ◽  
Kinase Inhibitor ◽  
Anaplastic Thyroid Cancer ◽  
Anaplastic Thyroid Carcinoma ◽  
Search Terms

BackgroundThere is a high unmet need for effective systemic treatment for patients with metastatic radioactive iodine refractory (RAI-R) differentiated thyroid cancer (DTC) and anaplastic thyroid cancer (ATC). Immunotherapy may be used as an alternative option for those without targetable mutations or have become resistant to targeted therapy. Here we review the clinical trials and retrospective studies and discuss the potential role of immune checkpoint inhibitors (ICIs) in advanced thyroid cancer.MethodsThe details of pertinent clinical trials were obtained from clinicaltrials.gov (NIH) using search terms including ‘thyroid cancer’ and ‘immunologic.’ The NCT numbers and search terms were used to search for published results on databases such as PubMed, American Association of Cancer Research, and American Society of Clinical Oncology. The efficacy outcome measures were determined using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.ResultsIn RAI-R DTC, responses to three different regimens have been reported: pembrolizumab, nivolumab plus ipilimumab, and pembrolizumab plus lenvatinib. No CR was reported, and the overall response rates (ORRs) varied from 9% (pembrolizumab monotherapy and nivolumab plus ipilimumab) to 64% (pembrolizumab plus lenvatinib) (figure 1a).1–4 In ATC, four studies have reported favorable outcomes in the context of dabrafenib and trametinib.5 The efficacy of spartalizumab, a PD1-inhibitor, was evaluated in a phase I/II trial, rendering an ORR of 19%, with 3 CRs (7%) and 5 PRs (12%) [6]. The study of nivolumab plus ipilimumab reported an ORR of 30% in ATC, with a near CR and two without clear evidence of disease at 13 and 26 months.2 A trial that tested the combination of atezolizumab, vemurafenib, and cobimetinib in BRAFV600E-mutated patients reported an ORR of 59%.7 A retrospective study reported an ORR of 60% after adding pembrolizumab at the time of progression on lenvatinib8 (figure 1b). There are 25 ongoing trials evaluating the efficacy of ICIs in different types of thyroid cancer. Three trials are testing pembrolizumab as monotherapy, three trials are assessing ICI combination therapy, and six trials are testing the efficacy of various ICI and tyrosine kinase inhibitor (TKI) combinations (figure 2).Abstract 204 Figure 1Comparison of responses in different regimens*The study population consisted only of BRAFV600E-positive patients**Retrospective studyAbbreviations: CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; Uneval; unevaluable; PEM, pembrolizumab; IPI, ipilimumab; NIVO, nivolumab; LENV, lenvatinib; ATEZO, atezolizumab; VEM, vemurafenib; COBI, cobimetinib; DAB, dabrafenib; TRAME, trametinib.Abstract 204 Figure 2comparison of responses in different regimensA. Number of checkpoint inhibition trials for various thyroid cancer histologies. B. Landscape of combination checkpoint inhibition agents.Abbreviations: DTC, differentiated thyroid cancer; ATC, anaplastic thyroid cancer, MTC, medullary thyroid cancer; NIVO, nivolumab; IPI, ipilimumab; LENV, lenvatinib; ATEZO, atezolizumab; VEM, vemurafenib; COBI, cobimetinib, DAB, dabrafenib; TRAME, trametinib; PEM, pembrolizumab; DOXY, doxycycline; SBRT: Stereotactic radiation therapy.ConclusionsThe recent trials and a retrospective study have reported favorable outcomes in ATC, suggesting ICIs have a potential role in treating patients with ATC. In particular, dual ICIs or combination of TKI and ICI can be developed as treatment options for ATC. Further large scale randomized prospective studies are required to establish ICIs as standard of care.ReferencesMehnert JM, et al. Pembrolizumab for advanced papillary or follicular thyroid cancer: preliminary results from the phase 1b KEYNOTE-028 study. Journal of Clinical Oncology 2016; 34: 6091–6091.Lorch JH, et al. A phase II study of nivolumab (N) plus ipilimumab (I) in radioidine refractory differentiated thyroid cancer (RAIR DTC) with exploratory cohorts in anaplastic (ATC) and medullary thyroid cancer (MTC). Journal of Clinical Oncology38, no. 15_suppl (May 20, 2020) 6513–6513.Haugen B, et al. Lenvatinib plus pembrolizumab combination therapy in patients with radioiodine-refractory (RAIR), progressive differentiated thyroid cancer (DTC): Results of a multicenter phase II international thyroid oncology group trial. Journal of Clinical Oncology38, no. 15_suppl (May 20, 2020) 6512–6512.Schlumberger M, et al. Lenvatinib versus placebo in radioiodine-refractory thyroid cancer. N Engl J Med 2015; 372:621–30.Subbiah V, et al. Dabrafenib and Trametinib Treatment in Patients With Locally Advanced or Metastatic BRAF V600-Mutant Anaplastic Thyroid Cancer. Journal of Clinical Oncology 2018; 36:7–13.Capdevila J, et al. PD-1 Blockade in anaplastic thyroid carcinoma. Journal of Clinical Oncology38, no. 23 (August 10, 2020) 2620–2627.Cabanillas ME, et al. Atezolizumab combinations with targeted therapy for anaplastic thyroid carcinoma (ATC). Journal of Clinical Oncology 2020;38(15).Iyer PC, et al. Salvage pembrolizumab added to kinase inhibitor therapy for the treatment of anaplastic thyroid carcinoma. J Immunother Cancer 2018;6:68.

scholarly journals A case report of anaplastic thyroid cancer and papillary thyroid cancer lymph node metastasis: An unusual presentation as an invasive hypopharyngeal mass

2021 ◽  
Author(s):  
Veena Vishwanath ◽  
Nichola Gaunt ◽  
Durgesh Rana ◽  
Dominic St Leger ◽  
Michael Dykes ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Cancer ◽  
Cancer Metastasis ◽  
Braf Inhibitor ◽  
Anaplastic Thyroid Cancer ◽  
Unusual Presentation ◽  
Braf V600e ◽  
Papillary Thyroid ◽  
Dismal Prognosis

Anaplastic thyroid carcinoma is a rare undifferentiated tumour of the thyroid follicular epithelium. It almost always develops from a pre-existing well-differentiated thyroid cancer with a co-existent thyroid malignancy varying from 5-17% . The co-existence of papillary thyroid cancer (PTC) with anaplastic thyroid cancer is a rare occurrence in metastases outside the primary thyroid lesion. Traditionally, this has been regarded as an aggressive form of cancer associated with a dismal prognosis. Recently the focus has shifted to the development of novel therapies based on the availability of comprehensive genomic profiling platforms (CGP) with a rapid turn-around to identify molecular aberrations in tumours which acts as potential therapeutic targets. In the United Kingdom, we report the case of a 60-year old woman with an unusual presentation of (metastatic) ATC and concomitant papillary thyroid cancer metastasis within a contralateral lymph node. This was initially perceived as a left pyriform fossa mass involving and compressing her left hemi-larynx on clinical and radiological examination. Following the identification of BRAF V600E mutation on CGP, she was started on targeted therapy with the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib and demonstrated excellent clinical and radiological response following 7 months of treatment. She has subsequently undergone total thyroidectomy alongside with bilateral neck dissection, and is due to start radio-active iodine treatment to reduce the risk of recurrence of disease.

Sign in / Sign up

Export Citation Format

Share Document