Case Report: Locally invasive thyroid metastases from renal cell carcinoma: surgery after neoadjuvant therapy
ObjectiveNeoadjuvant therapy is under investigation not only for unresectable clear cell renal cell carcinoma (ccRCC) (1) but also for locally invasive primary thyroid cancers (2). Herein, we describe two cases of locally invasive thyroid metastases from ccRCC treated surgically after neoadjuvant th...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1543060/full |
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| author | Dana M. Hartl Mohamed-Amine Bani Abir Al Ghuzlan Andreea-Elena Simonescu Ingrid Breuskin Alix Marhic Laurence Albiges Laurence Albiges Livia Lamartina Livia Lamartina Julien Hadoux Julien Hadoux |
| author_facet | Dana M. Hartl Mohamed-Amine Bani Abir Al Ghuzlan Andreea-Elena Simonescu Ingrid Breuskin Alix Marhic Laurence Albiges Laurence Albiges Livia Lamartina Livia Lamartina Julien Hadoux Julien Hadoux |
| author_sort | Dana M. Hartl |
| collection | DOAJ |
| description | ObjectiveNeoadjuvant therapy is under investigation not only for unresectable clear cell renal cell carcinoma (ccRCC) (1) but also for locally invasive primary thyroid cancers (2). Herein, we describe two cases of locally invasive thyroid metastases from ccRCC treated surgically after neoadjuvant therapy to highlight the rationale and outcomes.Patients and methodsTwo patients, one woman and one man, both age 69, developed unresectable thyroid metastases from ccRCC, respectively, 20 and 13 years after nephrectomy for ccRCC. Patient 1 received lenvatinib and a bispecific anti–Programmed cell Death protein 1/ cytotoxic T-lymphocyte-associated protein 4 (PD-1/CTLA-4) antibody in the context of a clinical trial. The second patient received nivolumab and cabozantinib.ResultsThe observed tumor response in patient 1 showed a decrease in mean surgical complexity score from unresectable (prevertebral fascia invasion) to severe (risk of recurrent nerve paralysis) and in patient 2 from unresectable (prevertebral fascia) to moderate (superficial esophageal invasion). The recurrent nerve was invaded in patient 1, leading to a subtotal resection. Surgery was a total thyroidectomy extended to the internal jugular vein in patient 2. Hospitalization was 1 and 2 days, respectively. Postoperative dysphonia improved in patient 1 after 3 months. No complications occurred in the second patient, who received adjuvant radiation therapy. After surgery, systemic therapy was discontinued in both patients, and stable residual oligometastatic disease was followed.ConclusionNeoadjuvant therapy enabled a macroscopic resection of locally invasive thyroid metastases, preserving laryngeal function and allowing discontinuation of systemic therapy. This approach may be considered in these rare cases, although the impact on progression-free or overall survival is currently unknown. |
| format | Article |
| id | doaj-art-0bd6b3a3192a40baa126b4ca3a47e193 |
| institution | OA Journals |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-0bd6b3a3192a40baa126b4ca3a47e1932025-08-20T02:30:14ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15430601543060Case Report: Locally invasive thyroid metastases from renal cell carcinoma: surgery after neoadjuvant therapyDana M. Hartl0Mohamed-Amine Bani1Abir Al Ghuzlan2Andreea-Elena Simonescu3Ingrid Breuskin4Alix Marhic5Laurence Albiges6Laurence Albiges7Livia Lamartina8Livia Lamartina9Julien Hadoux10Julien Hadoux11Division of Surgery and Anesthesiology, Head and Neck Oncology Service, Thyroid Surgery Unit, Gustave Roussy Cancer Campus Grand Paris, Villejuif, FranceDepartment of Pathology, Gustave Roussy Cancer Campus, Villejuif, FranceDepartment of Pathology, Gustave Roussy Cancer Campus, Villejuif, FranceDepartment of Pathology, Gustave Roussy Cancer Campus, Villejuif, FranceDivision of Surgery and Anesthesiology, Head and Neck Oncology Service, Thyroid Surgery Unit, Gustave Roussy Cancer Campus Grand Paris, Villejuif, FranceDivision of Surgery and Anesthesiology, Head and Neck Oncology Service, Thyroid Surgery Unit, Gustave Roussy Cancer Campus Grand Paris, Villejuif, FranceDepartment of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, FranceUniversity of Paris-Saclay, Le Kremlin-Bicêtre, FranceDepartment of Medical Imaging, Endocrine Oncology Service, Gustave Roussy Cancer Campus, Villejuif, FranceEndocan-Tuthyref Network, Villejuif, FranceDepartment of Medical Imaging, Endocrine Oncology Service, Gustave Roussy Cancer Campus, Villejuif, FranceEndocan-Tuthyref Network, Villejuif, FranceObjectiveNeoadjuvant therapy is under investigation not only for unresectable clear cell renal cell carcinoma (ccRCC) (1) but also for locally invasive primary thyroid cancers (2). Herein, we describe two cases of locally invasive thyroid metastases from ccRCC treated surgically after neoadjuvant therapy to highlight the rationale and outcomes.Patients and methodsTwo patients, one woman and one man, both age 69, developed unresectable thyroid metastases from ccRCC, respectively, 20 and 13 years after nephrectomy for ccRCC. Patient 1 received lenvatinib and a bispecific anti–Programmed cell Death protein 1/ cytotoxic T-lymphocyte-associated protein 4 (PD-1/CTLA-4) antibody in the context of a clinical trial. The second patient received nivolumab and cabozantinib.ResultsThe observed tumor response in patient 1 showed a decrease in mean surgical complexity score from unresectable (prevertebral fascia invasion) to severe (risk of recurrent nerve paralysis) and in patient 2 from unresectable (prevertebral fascia) to moderate (superficial esophageal invasion). The recurrent nerve was invaded in patient 1, leading to a subtotal resection. Surgery was a total thyroidectomy extended to the internal jugular vein in patient 2. Hospitalization was 1 and 2 days, respectively. Postoperative dysphonia improved in patient 1 after 3 months. No complications occurred in the second patient, who received adjuvant radiation therapy. After surgery, systemic therapy was discontinued in both patients, and stable residual oligometastatic disease was followed.ConclusionNeoadjuvant therapy enabled a macroscopic resection of locally invasive thyroid metastases, preserving laryngeal function and allowing discontinuation of systemic therapy. This approach may be considered in these rare cases, although the impact on progression-free or overall survival is currently unknown.https://www.frontiersin.org/articles/10.3389/fonc.2025.1543060/fullrenal cell carcinomathyroidmetastasisneoadjuvant therapykinase inhibitorsimmunotherapy |
| spellingShingle | Dana M. Hartl Mohamed-Amine Bani Abir Al Ghuzlan Andreea-Elena Simonescu Ingrid Breuskin Alix Marhic Laurence Albiges Laurence Albiges Livia Lamartina Livia Lamartina Julien Hadoux Julien Hadoux Case Report: Locally invasive thyroid metastases from renal cell carcinoma: surgery after neoadjuvant therapy Frontiers in Oncology renal cell carcinoma thyroid metastasis neoadjuvant therapy kinase inhibitors immunotherapy |
| title | Case Report: Locally invasive thyroid metastases from renal cell carcinoma: surgery after neoadjuvant therapy |
| title_full | Case Report: Locally invasive thyroid metastases from renal cell carcinoma: surgery after neoadjuvant therapy |
| title_fullStr | Case Report: Locally invasive thyroid metastases from renal cell carcinoma: surgery after neoadjuvant therapy |
| title_full_unstemmed | Case Report: Locally invasive thyroid metastases from renal cell carcinoma: surgery after neoadjuvant therapy |
| title_short | Case Report: Locally invasive thyroid metastases from renal cell carcinoma: surgery after neoadjuvant therapy |
| title_sort | case report locally invasive thyroid metastases from renal cell carcinoma surgery after neoadjuvant therapy |
| topic | renal cell carcinoma thyroid metastasis neoadjuvant therapy kinase inhibitors immunotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1543060/full |
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