Case report demonstrates tumor shrinkage and safe resection with neoadjuvant lenvatinib in locally advanced papillary thyroid carcinoma, indicating a strategy to preserve critical vessels.
We report a 65-year old female with advanced papillary thyroid carcinoma involving the critical vessels including common carotid artery (CCA). She initially refused surgery and lenvatinib (LEN) was used in neoadjuvant setting. Primary tumor effectively shrank by LEN without any critical adverse effect. Total thyroidectomy and modified neck dissection were curatively performed. Tumor invading into internal jugular vein exhibited remarkable response to LEN and was almost replaced with necrosis and fibrosis. CCA was surrounded by fibrosis but was smoothly dissected from tumor and preserved. The patient shows no sign of recurrence for 2 years after surgery at present. Neoadjuvant LEN treatment can be new option for locally advanced papillary thyroid carcinoma involving critical vessels, particularly CCA, to reduce risk of surgical morbidity.
No takes yet. Share an insight, caveat, or question.
Katoh et al. (2020) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: