Anaplastic thyroid cancer with long‑term survival with lenvatinib therapy and preservation of laryngeal function after one‑stage reconstruction: A case report

Abstract

Laryngotracheal reconstruction is performed to treat locally advanced thyroid carcinoma invading the larynx and/or trachea. The reconstructive technique varies. The present report describes the case of a 71-year-old female patient who underwent surgery for thyroid carcinoma involving the larynx. Reconstructive surgical techniques were employed to maintain laryngeal structure and function. An anterolateral thigh flap with free rib cartilage grafts was used to compensate for laryngeal defects. Although a temporary tracheal stoma was constructed, it closed spontaneously after decannulation. Therefore, one-stage laryngeal reconstruction was accomplished. Post-operative histopathological examination revealed focal anaplastic changes in the lesion, which mainly consisted of papillary components. Post-operative positron emission tomography/computed tomography indicated early recurrence in the left side of the neck. Therefore, lenvatinib was started as adjuvant therapy. Complete response was observed with lenvatinib therapy. The patient was alive and had good laryngeal function 26 months after the operation. One-stage laryngeal reconstruction can reduce burden and improve quality of life in patients with thyroid carcinoma involving the larynx. Lenvatinib may be useful for treating early recurrence of anaplastic thyroid carcinoma after reconstructive surgery with a free flap.

Novel Inhibitor-Based Therapies for Thyroid Cancer—An Update

“…Lenvatinib, an oral multitarget inhibitor, has been used in adjuvant therapy after thyroidectomy with neck dissection and postoperative chemoradiotherapy. Therapy extended the time to progression, but some AEs, like HT fatigue, anorexia and severe drug-induced hepatitis, forced investigators to taper the drug dose [ 144 , 145 ]. Results of treatment of ATC patients with lenvatinib (phase II trial) confirmed tumor size reduction (in more than half of evaluated patients), PR to treatment ( n = 1) and >30% reduction in the total size of the target lesion.…”