ESMO Preceptorship Programme

Anaplastic Thyroid Carcinoma

Lim, Imee Loren C., MD

Medical Oncology, fellow-in-training

University of Santo Tomas Hospital

Philippines

Head and Neck– Hong Kong – April 13-14, 2019

ESMO PRECEPTORSHIP PROGRAMME

DISCLOSURE OF INTEREST

� None

ESMO PRECEPTORSHIP PROGRAMME

C.P. 63/F

� July 2017 – dysphagia

– CT neck 7/12/17: enlarged right thyroid gland with

heterogenous mass (3.7x3.4x2.7cm) consider neoplasm;

multiple bilateral cervical lymphadenopathies 0.3-1.3cm

– Incision biopsy: Papillary Cancer

� Sept 2017 – total thyroidectomy = Papillary thyroid

cancer, well differentiated (pT1N0M0)

– 3..5 x 2 x 1.5 cm, no LVI, negative LN 0/14

� Oct 2017 – RAI treatment

ESMO PRECEPTORSHIP PROGRAMME

C.P. 63/F

� July 2018 = mass below angle of right mandible

– Utz guided needle biopsy of right LN: malignant

ANAPLASTIC carcinoma, metastatic consistent with

thyroid gland primary

– MRI: soft tissue mass 3.2 x 2.8 x 4cm level II-III, right

side of the neck encasing the right common carotid

artery with possible infiltration of strap muscles

– Metastatic workup: NEGATIVE

– PE: 3x3cm fixed mass right level II neck

ESMO PRECEPTORSHIP PROGRAMME

C.P. 63/F

� Multidisciplinary meeting with Radiation Oncology,

Head and Neck Surgery, Medical Oncology

– Plan: External beam RT +/- weekly low dose

doxorubicin

• RT: August 13 to September 24, 2018

• Chemo: September 1 to November 19, 2018

of weekly doxorubin 20mg/m2 (7 cycles)

–Gr 3 dysphagia and dermatitis (Sept 17)

ESMO PRECEPTORSHIP PROGRAMME

C.P. 63/F

� Clinically partial response: 6.5x5.5cm � 4x4cm

(38% reduction)

� Lost to follow up

ESMO Preceptorship Programme