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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
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