Abstract
Case 1 : The patient underwent total thyroidectomy with tracheal resection, followed by local recurrence. Radioactive iodine (RAI) (I131), external beam radiotherapy (EBRT) and sorafenib were administered ; however, the disease progressed, thus lenvatinib was prescribed. During the next three months, perforation of the trachea was detected and lenvatinib was withdrawn. One month later, the tracheal fistula closed naturally. Case 2 : The patient underwent total thyroidectomy, followed by local recurrence. EBRT and chemotherapy was administered but was ineffective. Lenvatinib was initiated and with in a week, skin perforation was observed, which was quickly resolved. Case 3 : The patient was diagnosed with papillary thyroid cancer and bone metastasis in C6 of the spine. The patient initially underwent EBRT, followed by total thyroidectomy. However, local recurrence with invasion to the esophagus was detected and stenosis of the esophagus worsened. Lenvatinib was initiated and within a week, perforation of the esophagus led to its discontinuation. The fistula closed naturally within three months.
The possibility of perforation should be noted in cases of invasive thyroid cancer in which lenvatinib is prescribed after EBRT ; however, perforation can be cured naturally following discontinuation.
