2021 Volume 67 Issue 4 Pages 263-268
In this study, we report a case of papillary thyroid cancer (PTC) in which salvage surgery was performed during lenvatinib therapy and in which anaplastic transformation was diagnosed in a postoperative histological examination. The patient was an 80-year-old man who was diagnosed with PTC, with invasion to trachea and cervical esophagus and metastasis of mediastinal lymph node. With the aim of maintaining the patient's quality of life (QOL), we decided not to perform surgery and started lenvatinib therapy. The patient's QOL could be maintained with the continuation of lenvatinib therapy and without severe adverse events for approximately 2 years. However, because of swallowing dysfunction due to the progression of cervical esophagus invasion, total thyroid and laryngo-pharyngo-cervical esophagectomy and free jejunal flap were performed without tracheostomy in the anterior mediastinum. In the postoperative histological examination, one-third of the sample showed anaplastic transformation. At more than 1 year after surgery, no recurrence was observed in the local area, and the mediastinal lesions had continued to shrink.
