Survival of a Patient with Anaplastic Thyroid Cancer Following Neoadjuvant Chemotherapy Regimen ‘cisplatin doxorubicin’ And Surgery - A Case Report

Anaplastic thyroid carcinoma(ATC) is a rare, lethal disease with no effective systemic therapies. ATC usually manifests itself with the local symptoms due to a rapidly enlarging thyroid mass, that causing dysphagia, dysphonia or hoarseness, stridor, and dyspnea symptoms due to mass effect on the esophagus and trachea.
We report the case of a 56 year-old woman who was referred to our hospital due to swelling in the neck. A palpable, hard, immobile tumor was observed in the left side of his neck in thyroid, along with a swollen, palpable, immobile lymph node. The patient underwent chemotherapy regimen as cisplatin 75 mg/m2/day at D1, doxorubicin 60 mg/m2/day D1, every 21 days) regimen as first-line therapy for six cycles. No mass was detected in F18- FDG-PET after six cycled of chemotherapy. Complete remission was achieved radiologically. The patient underwent surgery after two weeks. Total thyroidectomy, bilateral central and left modified radical cervical lymph node dissection were performed. A surgical complete R0 resection was achieved.
The best results in terms of survival are obtained with a multidisciplinary treatment combining surgery, external beam radiotherapy and chemotherapy. Despite multidisciplinary treatment, responses to treatment are not promising. Neoadjuvant chemotherapy can be a preferable choice especially for the one who have a little chance for surgical complete R0 resection.

Neoadjuvan Kemoterapi Rejimi 'sisplatin doksorubisin' ve Cerrahinin Ardýndan Anaplastik Tiroid Kanseri Olan Bir Hastanýn Saðkalýmý - Bir Olgu Sunumu

Anaplastik tiroid karsinomu (ATC), etkili sistemik tedavileri olmayan nadir görülen, ölümcül bir hastalýktýr. ATC genellikle hýzlý büyüyen tiroid kitlesi ile birlikte özofagus ve trakeadaki kitle etkisine baðlý olarak disfaji, disfoni veya ses kýsýklýðý, stridor ve dispne semptomlarýna neden olan lokal semptomlarla gösterir.
Boyunda þiþlik nedeniyle hastanemize sevk edilen 56 yaþýndaki kadýn hasta olgusunu sunuyoruz. Tiroidde boynunun sol tarafýnda palpe edilebilen, sert, hareketsiz bir tümör ve palpe edilebilen, hareketsiz bir lenf nodu saptandý. Hastaya birinci basamak tedavi olarak 75 mg / m2 / gün cisplatin, 21 günde bir doksorubisin 60 mg / m2 / gün 21 günde bir 6 kür kemoterapi rejimi uygulandý. 6 kür kemoterapi sonrasý F18-FDG-PET’ de kitle saptanmadý. Radyolojik olarak tam remisyon saðlandý. Hasta 2 hafta sonra opere edildi. Total tiroidektomi, bilateral santral ve sol modifiye radikal servikal lenf nodu diseksiyonu yapýldý. Cerrahi olarak tam R0 rezeksiyonu saðlandý.
Saðkalým açýsýndan en iyi sonuçlar, cerrahi, eksternal radyoterapi ve kemoterapiyi birleþtiren multidisipliner bir tedavi ile elde edilir. Fakat multidisipliner tedaviye raðmen, tedaviye yanýtlar umut verici deðildir. Birinci basamak neadjuvan kemoterapi rejimleri, özellikle cerrahi tam R0 rezeksiyon þansý az olan hastalarda tercih edilebilir bir seçenek olabilir.