ABSTRACT
Pembrolizumab, a programmed death 1 inhibitor, has been shown to have clinically significant efficacy in different types of cancer, providing long-term survival benefit for patients with lung cancer. Herein, we report the development of a primary thyroid cancer in a lung cancer patient that was being treated with pembrolizumab. Primary thyroid malignancy (and not only metastatic disease or immunotherapy-induced thyroiditis) should be considered in patients with lung cancer being treated with immune checkpoint inhibitors who develop new incidental thyroid lesions on imaging studies.
Subject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Carcinoma, Non-Small-Cell Lung/drug therapy , Immunotherapy/adverse effects , Lung Neoplasms/drug therapy , Thyroid Neoplasms/chemically induced , Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents, Immunological/adverse effects , Carcinoma, Non-Small-Cell Lung/diagnosis , Diagnosis, Differential , Humans , Lung Neoplasms/diagnosis , Male , Middle Aged , Positron-Emission Tomography , Thyroid Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
Presentamos el primer caso clínico de metástasis cerebelosa de carcinoma folicular de tiroides. Se trata de una mujer de 78 años de edad, que fue sometida a tiroidectomía total, hace 23 años cuyo estudio histológico fue de adenoma de tiroides atípico en el lóbulo tiroideo izquierdo. Los niveles séricos de tiroglobulina (Tg) aumentaron en las revisiones posteriores. Los niveles de anticuerpos anti-tiroglobulina fueron siempre negativos. Recibió tratamiento con radioyodo en varias ocasiones. En el estudio de seguimiento una nueva TC reveló una lesión a nivel de hemisferio cerebeloso izquierdo. La paciente fue sometida a resección quirúrgica de esta lesión. Los hallazgos inmunohistoquímicos mostraron un origen tiroideo de la metástasis, con células tumorales con positividad difusa e intensa para citoqueratina-7 (CK7), factor de transcripción tiroideo-1 (TTF-1) y positiva focal para Tg, y débil para CK19, y negatividad para PGAF, galectina-3 y CK20. El análisis de las mutaciones V600E y V600K del gen BRAF fue negativa (AU)
We present here, for the first time, a case of cerebellar metastasis from a follicular thyroid carcinoma. A 78 year-old woman had undergone total thyroidectomy 23 years previously for an atypical thyroid adenoma in the left thyroid lobe. Serum thyroglobulin (tg) levels subsequently increased but thyroglobulin antibody levels were always negative. She received radioiodine therapy on several occasions. In the follow-up localizing study a whole body CT scan revealed an image at the left cerebellar hemisphere level. The patient underwent surgery for the cerebellar lesion and immunohistochemistry revealed it to be a metastasis of thyroid origin; the tumour cells had diffuse and intense positivity for cytokeratin-7 (CK7), thyroid transcription factor-1 (TTF-1) and tg, focal and weak positivity for CK19 and negativity for PGAF, galectin-3 and CK20. The analysis of V600K V600E BRAF gene mutations was negative (AU)
