Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2023; 11(12): 2839-2847
Published online Apr 26, 2023. doi: 10.12998/wjcc.v11.i12.2839
Efficacy of anlotinib combined with radioiodine to treat scalp metastasis of papillary thyroid cancer: A case report and review of literature
Li-Yong Zhang, Shao-Jun Cai, Bo-Yan Liang, Shou-Yi Yan, Bo Wang, Meng-Yao Li, Wen-Xin Zhao
Li-Yong Zhang, Shao-Jun Cai, Bo-Yan Liang, Shou-Yi Yan, Bo Wang, Meng-Yao Li, Wen-Xin Zhao, Department of Thyroid Surgery, General Surgery, Minimal Invasive Center, The Training Center for Intraoperative Neurophysiologic Monitoring of Thyroid and Parathyroid, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou 350001, Fujian Province, China
Author contributions: Zhang LY and Zhao WX contributed to the study design; Liang BY and Yan SY contributed to the data collection; Cai SJ, Wang B and Li MY contributed to the data analysis and interpretation; Zhang LY, Cai SJ and Yan SY wrote the draft; Wang B, Li MY and Zhao WX contributed to the revising/editing draft; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Xin Zhao, PhD, Professor, Department of Thyroid Surgery, General Surgery, Minimal Invasive Center, The Training Center for Intraoperative Neurophysiologic Monitoring of Thyroid and Parathyroid, Fujian Medical University Union Hospital, Fujian Medical University, No. 29 Xinquan Road, Fuzhou 350001, Fujian Province, China. zhaowx@fjmu.edu.cn
Received: December 30, 2022
Peer-review started: December 30, 2022
First decision: January 17, 2023
Revised: February 27, 2023
Accepted: March 22, 2023
Article in press: March 22, 2023
Published online: April 26, 2023
Abstract
BACKGROUND

Papillary thyroid cancer (PTC) is one of the well-differentiated thyroid tumors. Cutaneous metastasis from differentiated thyroid cancers occurs in < 1% of primary thyroid carcinomas but produces the worst survival prognosis. The multi-targeting tyrosine kinase inhibitor anlotinib has been approved to treat refractory advanced non-small-cell lung cancer as well as advanced soft-tissue and clear cell sarcomas in China.

CASE SUMMARY

In a patient with scalp metastasis caused by PTC, thyroid and skull metastasis tumor sizes were significantly reduced after a trial of neoadjuvant anlotinib therapy for 3 cycles. Anlotinib maintenance medication after thyroidectomy further reduced the metastatic skull tumor size thereby preventing the requirement for craniotomy.

CONCLUSION

The outcome of the present trial confirmed the potential of anlotinib therapy to treat scalp metastasis induced by PTC and point the way for the treatment of similar diseases in the future.

Keywords: Papillary thyroid cancer, Tyrosine kinase inhibitor, Neoadjuvant anlotinib therapy, Literature review, Case report

Core Tip: Cutaneous metastasis to the scalp is a site in patients which occurs after papillary thyroid cancers (PTC). Tyrosine kinase inhibitors represent a new approach to treat certain types of thyroid cancer. Here we report a case of scalp metastasis caused by PTC, in which neoadjuvant therapy of anlotinib before thyroidectomy was beneficial in reducing the thyroid and skull metastasis tumor sizes. Anlotinib maintenance regimen after thyroidectomy reduced the size of the metastatic skull tumor further, which successfully avoided the need for craniotomy.