Treatment for advanced differentiated thyroid cancer with multiple distant me-tastases (case report)

Carcinogenesis is a polypathogenetic process, and monotherapy of cancer, in particular metastatic cancer, is clearly inadequate. This case report illustrates medical errors in the management of advanced differentiated thyroid cancer in a 51-year-old woman. Due to the rarity of such patients, specialists chose the wrong management strategy, i.e., thyroidectomy was not performed (e.g., the origin of metastases was not removed), radioiodine therapy was categorically denied (although it is the first-line treatment for such patients), brain metastases were not ablated, and suppressive therapy with levothyroxine was not prescribed. A protein kinase inhibitor with antitumor activity, lenvatinib, was prescribed for the treatment of advanced thyroid cancer. Meanwhile, this medication is used in radioiodine resistance that could not be established in this woman. Lenvatinib has many complications, including fatal ones, and the treatment course can be completed in ≈25% only. Poorly controlled hypertension immediately developed after staring treatment with protease inhibitor. The pros and cons of a new group of anticancer medications, tyrosine kinase inhibitors, are described in detail. Pos-sible treatment outcomes are addressed. KEYWORDS: differentiated thyroid cancer, papillary thyroid cancer, tyrosine kinase inhibitors, I-131 radiotherapy, lenvatinib, metastasis. FOR CITATION: Tereshchenko I.V. Treatment for advanced differentiated thyroid cancer with multiple distant me-tastases (case report). Russian Medical Inquiry. 2023;7(6):387–390 (in Russ.). DOI: 10.32364/2587-6821-2023-7-6-8.