Cargando…
Heart Failure as First Sign of Development of Cardiac Metastases in a Patient with Diagnosis of Papillary Thyroid Carcinoma on Treatment with Tyrosine-Kinase Inhibitors: Differential Diagnoses and Clinical Management
BACKGROUND: Cardiac metastases from papillary thyroid carcinoma are very uncommon. Their incidence is rising due to improvements in survival and diagnosis; nevertheless, our patient is the fourth case reported up to date. There are no clinical trials available in this scenario. Therefore, treatment...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4178319/ https://www.ncbi.nlm.nih.gov/pubmed/25298765 http://dx.doi.org/10.1159/000366192 |
_version_ | 1782336933131714560 |
---|---|
author | Bruixola, Gema Segura, Ángel Caballero, Javier Andrés, Ana Reche, Encarnación Escoín, Corina Díaz-Beveridge, Roberto |
author_facet | Bruixola, Gema Segura, Ángel Caballero, Javier Andrés, Ana Reche, Encarnación Escoín, Corina Díaz-Beveridge, Roberto |
author_sort | Bruixola, Gema |
collection | PubMed |
description | BACKGROUND: Cardiac metastases from papillary thyroid carcinoma are very uncommon. Their incidence is rising due to improvements in survival and diagnosis; nevertheless, our patient is the fourth case reported up to date. There are no clinical trials available in this scenario. Therefore, treatment choice is made based on clinical experience and case reports; notably, the largest case report series was prior to the approval for using tyrosine-kinase inhibitors in thyroid cancer. PATIENT: A 73-year-old lady had dedifferentiated papillary thyroid cancer with ongoing sorafenib. After 9 months on this treatment, she presented with dyspnea and heart failure. Differential diagnosis included infection, progression of disease and cardiotoxicity. After a comprehensive assessment (echocardiography, computed tomography, PET, magnetic resonance), we found progression of lung disease, and the appearance of heart metastases. RESULTS: After recovering from the basal status, she started on second-line treatment with sunitinib, which was well-tolerated. She achieved stable disease with a decrease in tumor marker levels. CONCLUSIONS: We should include cardiac metastases in the differential diagnosis of heart failure in cancer patients. Magnetic resonance imaging is the gold standard for assessment. Sorafenib is the mainstay of the first-line therapy in metastatic thyroid cancer, achieving long-term disease control with good tolerance. Sunitinib could be a safe second-line treatment option (not cardiotoxicity related) with promising results. Therefore, our report presents a sequence of treatment with tyrosine-kinase inhibitors in metastatic thyroid carcinoma with an encouraging outcome, which deserves further investigation. |
format | Online Article Text |
id | pubmed-4178319 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-41783192014-10-08 Heart Failure as First Sign of Development of Cardiac Metastases in a Patient with Diagnosis of Papillary Thyroid Carcinoma on Treatment with Tyrosine-Kinase Inhibitors: Differential Diagnoses and Clinical Management Bruixola, Gema Segura, Ángel Caballero, Javier Andrés, Ana Reche, Encarnación Escoín, Corina Díaz-Beveridge, Roberto Case Rep Oncol Published online: August, 2014 BACKGROUND: Cardiac metastases from papillary thyroid carcinoma are very uncommon. Their incidence is rising due to improvements in survival and diagnosis; nevertheless, our patient is the fourth case reported up to date. There are no clinical trials available in this scenario. Therefore, treatment choice is made based on clinical experience and case reports; notably, the largest case report series was prior to the approval for using tyrosine-kinase inhibitors in thyroid cancer. PATIENT: A 73-year-old lady had dedifferentiated papillary thyroid cancer with ongoing sorafenib. After 9 months on this treatment, she presented with dyspnea and heart failure. Differential diagnosis included infection, progression of disease and cardiotoxicity. After a comprehensive assessment (echocardiography, computed tomography, PET, magnetic resonance), we found progression of lung disease, and the appearance of heart metastases. RESULTS: After recovering from the basal status, she started on second-line treatment with sunitinib, which was well-tolerated. She achieved stable disease with a decrease in tumor marker levels. CONCLUSIONS: We should include cardiac metastases in the differential diagnosis of heart failure in cancer patients. Magnetic resonance imaging is the gold standard for assessment. Sorafenib is the mainstay of the first-line therapy in metastatic thyroid cancer, achieving long-term disease control with good tolerance. Sunitinib could be a safe second-line treatment option (not cardiotoxicity related) with promising results. Therefore, our report presents a sequence of treatment with tyrosine-kinase inhibitors in metastatic thyroid carcinoma with an encouraging outcome, which deserves further investigation. S. Karger AG 2014-08-20 /pmc/articles/PMC4178319/ /pubmed/25298765 http://dx.doi.org/10.1159/000366192 Text en Copyright © 2014 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions. |
spellingShingle | Published online: August, 2014 Bruixola, Gema Segura, Ángel Caballero, Javier Andrés, Ana Reche, Encarnación Escoín, Corina Díaz-Beveridge, Roberto Heart Failure as First Sign of Development of Cardiac Metastases in a Patient with Diagnosis of Papillary Thyroid Carcinoma on Treatment with Tyrosine-Kinase Inhibitors: Differential Diagnoses and Clinical Management |
title | Heart Failure as First Sign of Development of Cardiac Metastases in a Patient with Diagnosis of Papillary Thyroid Carcinoma on Treatment with Tyrosine-Kinase Inhibitors: Differential Diagnoses and Clinical Management |
title_full | Heart Failure as First Sign of Development of Cardiac Metastases in a Patient with Diagnosis of Papillary Thyroid Carcinoma on Treatment with Tyrosine-Kinase Inhibitors: Differential Diagnoses and Clinical Management |
title_fullStr | Heart Failure as First Sign of Development of Cardiac Metastases in a Patient with Diagnosis of Papillary Thyroid Carcinoma on Treatment with Tyrosine-Kinase Inhibitors: Differential Diagnoses and Clinical Management |
title_full_unstemmed | Heart Failure as First Sign of Development of Cardiac Metastases in a Patient with Diagnosis of Papillary Thyroid Carcinoma on Treatment with Tyrosine-Kinase Inhibitors: Differential Diagnoses and Clinical Management |
title_short | Heart Failure as First Sign of Development of Cardiac Metastases in a Patient with Diagnosis of Papillary Thyroid Carcinoma on Treatment with Tyrosine-Kinase Inhibitors: Differential Diagnoses and Clinical Management |
title_sort | heart failure as first sign of development of cardiac metastases in a patient with diagnosis of papillary thyroid carcinoma on treatment with tyrosine-kinase inhibitors: differential diagnoses and clinical management |
topic | Published online: August, 2014 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4178319/ https://www.ncbi.nlm.nih.gov/pubmed/25298765 http://dx.doi.org/10.1159/000366192 |
work_keys_str_mv | AT bruixolagema heartfailureasfirstsignofdevelopmentofcardiacmetastasesinapatientwithdiagnosisofpapillarythyroidcarcinomaontreatmentwithtyrosinekinaseinhibitorsdifferentialdiagnosesandclinicalmanagement AT seguraangel heartfailureasfirstsignofdevelopmentofcardiacmetastasesinapatientwithdiagnosisofpapillarythyroidcarcinomaontreatmentwithtyrosinekinaseinhibitorsdifferentialdiagnosesandclinicalmanagement AT caballerojavier heartfailureasfirstsignofdevelopmentofcardiacmetastasesinapatientwithdiagnosisofpapillarythyroidcarcinomaontreatmentwithtyrosinekinaseinhibitorsdifferentialdiagnosesandclinicalmanagement AT andresana heartfailureasfirstsignofdevelopmentofcardiacmetastasesinapatientwithdiagnosisofpapillarythyroidcarcinomaontreatmentwithtyrosinekinaseinhibitorsdifferentialdiagnosesandclinicalmanagement AT recheencarnacion heartfailureasfirstsignofdevelopmentofcardiacmetastasesinapatientwithdiagnosisofpapillarythyroidcarcinomaontreatmentwithtyrosinekinaseinhibitorsdifferentialdiagnosesandclinicalmanagement AT escoincorina heartfailureasfirstsignofdevelopmentofcardiacmetastasesinapatientwithdiagnosisofpapillarythyroidcarcinomaontreatmentwithtyrosinekinaseinhibitorsdifferentialdiagnosesandclinicalmanagement AT diazbeveridgeroberto heartfailureasfirstsignofdevelopmentofcardiacmetastasesinapatientwithdiagnosisofpapillarythyroidcarcinomaontreatmentwithtyrosinekinaseinhibitorsdifferentialdiagnosesandclinicalmanagement |