Andrew G. Gianoukakis, MD

Case Impressions: A 73-Year-Old Woman With DTC

Recommendations for Treating Patients With DTC

Systemic Therapy for RAI-Refractory DTC

Lenvatinib Data for RAI-Refractory DTC

Real-World Insight: Lenvatinib for RAI-Refractory DTC

Progress in Treating RAI-Refractory DTC

Case: A 73-Year-Old Woman With Differentiated Thyroid Cancer

A 73-year-old woman complains of a “lump” on her neck, with occasional swelling and dysphagia

Ultrasound of the neck revealed a 3.0 cm mass in the right lobe of the thyroid; several suspicious lymph nodes ranging from 0.2-3.0 cm in size

Ultrasound-guided FNAB: confirmed papillary thyroid carcinoma

Patient underwent total thyroidectomy with bilateral central neck dissection

Pathology: 3.0 cm papillary thyroid cancer arising in right lobe of the thyroid, 2 of 5 positive central compartment lymph nodes, largest 1.4 cm, positive extra nodal extension

Levothyroxine to suppression was added to treatment regimen

Follow-up at 6 months TSH 0.4 µU/mL, thyroglobulin 4 ng/mL

Follow-up 12 months TSH 0.3 µU/mL, thyroglobulin 18 ng/mL

CT of the chest showed 10 lung nodules, largest 1.2 cm in size

Administered radioactive iodine 150 millicuries

Post therapy scan showed no lung or other uptake

Follow-up at 2 years TSH 0.3 µU/mL, thyroglobulin 30 ng/mL

Chest CT increasing number and size of lung nodules; largest 1.6 cm

Patient was asymptomatic and deemed radioactive iodine refractory

Systemic therapy with lenvatinib 24 mg PO qDay considered

Videos

Andrew G. Gianoukakis, MD, of Harbor-UCLA Medical Center, describes the rationale for treating a patient with RAI-refractory differentiated thyroid cancer with systemic therapy.

Andrew G. Gianoukakis, MD | Authors

Articles

A 73-Year-Old Woman With Differentiated Thyroid Cancer