Clinical case of successful treatment of a patient with anaplastic thyroid cancer in combination with ischemic heart disease and critical multivessel coronary artery disease

   The article presents a clinical case of a patient with locally advanced anaplastic thyroid cancer and concomitant cardiovascular pathology. Anaplastic thyroid cancer is a very rare and highly aggressive disease requiring long-term multistage treatment, often using cardiotoxic drugs. Combination of this pathology with ischemic heart disease affecting coronary arteries is a complex clinical problem requiring timely evaluation of cardiac risk at every stage. Treatment of this patient cohort is possible only by a multidisciplinary team of specialists.

1. The JAES/JSTS task force on the guidelines for thyroid tumors clinical practice guidelines on the management of thyroid tumors 2018. J JAES JSTS 2018;35:1–87.

2. Bray F., Ferlay J., Soerjomataram I. et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394–424. DOI: 10.3322/caac.21492

3. Smallridge R.C., Copland J.A. Anaplastic thyroid carcinoma: pathogenesis and emerging therapies. Clin Oncol 2010;22(6):486–97. DOI: 10.1016/j.clon.2010.03.013

4. Are C., Shaha A.R. Anaplastic thyroid carcinoma: biology, pathogenesis, prognostic factors, and treatment approaches. Ann Surg Oncol 2006;13(4):453–64. DOI: 10.1245/ASO.2006.05.042

5. Pathology and genetics of endocrine organs. WHO Classification of Tumours, 3^rd edn., V. 8. Ed. by R.A. de Lellis, R.V. Lloyd, P.U. Heitz, C. Eng. IARC Press, Lyon, France, 2004.

6. Sherman S.I. Anaplastic carcinoma: clinical aspects. In: Thyroid cancer: a comprehensive guide to clinical management. Ed. by L. Wartofsky, D. Van Nostrand. 2nd edn. Totowa: Humana Press, 2006. Pp. 629–632.

7. Untch B.R., Olson J.A. Jr. Anaplastic thyroid carcinoma, thyroid lymphoma, and metastasis to thyroid. Surg Oncol Clin N Am 2006;15(3):661–79. DOI: 10.1016/j.soc.2006.05.006

8. Asa S.L., Bedard Y.C. Fine-needle aspiration cytology and histopathology. In: Thyroid cancer: diagnosis and treatment. Ed. by O.H. Clark, S. Noguchi. St. Louis: Quality Medical Publishing, 2000. Pp. 105–126.

9. McIver B., Hay I.D., Giuffrida D.F. et al. Anaplastic thyroid carcinoma: a 50-year experience at a single institution. Surgery 2001;130(6):1028–34. DOI: 10.1067/msy.2001.118266

10. Lee D.Y., Won J.-K., Choi H.S. et al. Recurrence and survival after gross total removal of resectable undifferentiated or poorly differentiated thyroid carcinoma. Thyroid 2016;26(9):1259–68. DOI: 10.1089/thy.2016.0147

11. Pozdeyev N., Gay L.M., Sokol E.S. et al. Genetic analysis of 779 advanced differentiated and anaplastic thyroid cancers. Clin Cancer Res 2018;24(13):3059–68. DOI: 10.1158/1078-0432.CCR-18-0373

12. Mohebati A., Dilorenzo M., Palmer F. et al. Anaplastic thyroid carcinoma: a 25-year single-institution experience. Ann Surg Oncol 2014;21(5):1665–70. DOI: 10.1245/s10434-014-3545-5

13. Flaherty K.T., Infante J.R., Daud A. et al. Combined BRA F and MEK inhibition in melanoma with BRA F V600 mutations. N Engl J Med 2012;367(18):1694–703. DOI: 10.1056/NEJMoa1210093

14. Subbiah V., Kreitman R.J., Wainberg Z.A. et al. Dabrafenib and trametinib treatment in patients with locally advanced or metastatic BRA F V600-mutant anaplastic thyroid cancer. J Clin Oncol 2018;36(1):7–13. DOI: 10.1200/JCO.2017.73.6785

15. Capdevila J., Wirth L.J., Ernst T. et al. PD-1 blockade in anaplastic thyroid carcinoma. J Clin Oncol 2020; 38(23):2620–7. DOI: 10.1200/JCO.19.02727

16. Bastman J.J., Serracino H.S., Zhu Y. et al. Tumor-infiltrating T cells and the PD-1 checkpoint pathway in advanced differentiated and anaplastic thyroid cancer. J Clin Endocrinol Metab 2016;101(7):2863–73. DOI: 10.1210/jc.2015-4227

17. Quintana R.A., Monlezun D.J., Davogustto G. et al. Outcomes following percutaneous coronary intervention in patients with cancer. Int J Cardiol 2020;300:106–12. DOI: 10.1016/j.ijcard.2019.09.016