Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Complete response in anaplastic lymphoma kinase–rearranged oncocytic thyroid cancer: A case report and review of literature
Victoire de Salins, Gokoulakrichenane Loganadane, Charlotte Joly, Mukedaisi Abulizi, Maya Nourieh, Hélène Boussion, Yazid Belkacemi, Christophe Tournigand, Emmanuelle Kempf
Victoire de Salins, Charlotte Joly, Hélène Boussion, Christophe Tournigand, Emmanuelle Kempf, Department of Medical Oncology, Henri Mondor et Albert Chenevier Teaching Hospital, Assistance Publique – Hôpitaux de Paris, University of Paris-Est Creteil, Créteil 94010, France
Gokoulakrichenane Loganadane, Yazid Belkacemi, Department of Radiation Oncology and Breast Center, Henri Mondor University Hospital, Assistance Publique – Hôpitaux de Paris, University of Paris-Est Creteil and IMRB-INSERM 955 Team 21, Creteil 94010, France
Mukedaisi Abulizi, Department of Nuclear Medicine, Henri Mondor et Albert Chenevier Teaching Hospital, Assistance Publique – Hôpitaux de Paris, University of Paris-Est Creteil, Créteil 94010, France
Maya Nourieh, Department of Pathology, Henri Mondor et Albert Chenevier Teaching Hospital, Assistance Publique – Hôpitaux de Paris, University of Paris-Est Creteil, Créteil 94010, France
Author contributions: Kempf E, Joly C and de Salins V were the patient’s oncologist and resident, reviewed the literature, and contributed to manuscript drafting; de Salins V, Kempf E and Nourieh M wrote the manuscript; Tournigand C reviewed the literature and contributed to manuscript drafting; Nourieh M performed the anatomopathological analyses and interpretation, and contributed to manuscript drafting; Abulizi M analyzed and interpreted the imaging findings; Loganadane G and Belkacemi Y undertook the whole-brain radiation therapy and drafted the manuscript; Tournigand C, Kempf E, Boussion H and Joly C discussed and decided on the crizotinib treatment in multidisciplinary counselling; All authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Christophe Tournigand, MD, PhD, Chief Doctor, Full Professor, Department of Medical Oncology, Henri Mondor et Albert Chenevier Teaching Hospital, Assistance Publique – Hôpitaux de Paris, University of Paris-Est Creteil, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France.
christophe.tournigand@aphp.fr
Received: January 18, 2020
Peer-review started: January 18, 2020
First decision: April 12, 2020
Revised: May 26, 2020
Accepted: June 10, 2020
Article in press: June 10, 2020
Published online: July 24, 2020
Processing time: 183 Days and 15.5 Hours
BACKGROUND
Oncocytic carcinoma of the thyroid is a rare disease, characterized by a poor prognosis and low response rate to radioiodine therapy. Crizotinib is a specific anaplastic lymphoma kinase (ALK) inhibitor, which was initially developed in non-small cell lung cancer. Other solid tumors harboring a translocation in ALK have been described, such as renal carcinoma, thyroid, colorectal, ovarian cancers, and spitzoid melanoma. The research of ALK rearrangements in thyroid tumor is a promising therapeutic track, and treatments need to be explored.
CASE SUMMARY
We report the case of a 76-year-old woman with a history of multinodular goiter, who was hospitalized for impairment of her general condition. She was diagnosed with metastatic oncocytic thyroid cancer. Synchrone metastases were found: Multiple mediastinal lymphadenopathies, lytic bone lesions and bilateral mammary lumps. Fluorescence in situ hybridization analysis revealed an ALK rearrangement in 61% of cells. No other mutation was found. A tumor board discussion based on molecular characteristics of the tumor suggested initiating a daily treatment by crizotinib, a specific ALK inhibitor. A positron emission tomography scan performed 4 mo after the initiation of crizotinib showed a complete metabolic response.
CONCLUSION
This case highlights an unexpected efficacy of crizotinib in an ALK-rearranged thyroid tumor, and the need of further assessments.
Core tip: Oncocytic carcinoma of the thyroid is a rare disease, characterized by a poor prognosis and low response rate to radioiodine therapy. We present here a case of a 76-year-old woman who was diagnosed with metastatic oncocytic thyroid cancer. A rearrangement of the anaplastic lymphoma kinase (ALK) gene within the thyroid tumor was found, and the patient started a daily treatment of crizotinib, a specific ALK inhibitor. After 4 mo, an unexpected complete metabolic response was observed. The efficacy of crizotinib in an ALK-rearranged thyroid tumor is a promising therapeutic track and needs to be explored.
