Case report of refractory advanced thyroid oncocytic carcinoma

Thyroid Oncocytic carcinoma (OCA), a rare differentiated thyroid carcinoma subtype, accounts for approximately 3–7% of cases. This malignancy is high aggressive, frequently metastasizing, and poorly responsive to radioactive iodine therapy. Standardized treatment protocols are currently lacking because its rarity. We report the case of a 67-year-old female who presented with a large advanced thyroid tumor exceeding 9 cm in maximum diameter, accompanied by lung and bone metastases. The patient had a seven-year history of bilateral thyroid nodules and hoarseness. Histopathological examination confirmed OCA with vascular invasion. Given the inoperable nature of the tumor and the patient’s limited financial resources, we initiated combination therapy with lenvatinib (16 mg daily) and sorafenib (0.4 g twice daily). Subsequent imaging follow-up demonstrated controlled disease, allowing the patient to survive for over one year. In such advanced cases, tyrosine kinase inhibitors like sorafenib and lenvatinib have shown significant efficacy in controlling disease progression. This case highlights the aggressive nature of OCA and the therapeutic challenges posed by advanced, large tumors. While surgery remains the cornerstone of treatment, targeted therapies including lenvatinib and sorafenib provide viable options for patients with metastatic or refractory disease and can substantially prolong survival. This report adds to the limited literature on the management of advanced OCA.