THYROID CANCERS

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We present a case of a 49-year-old woman with a pT4aN1B papillary thyroid cancer who underwent radical thyroidectomy with bilateral neck dissection and RAI I-131 ablation, but poorly tolerated TSH suppression therapy due to tachycardia. Rising thyroglobulin levels and lymph node mapping showed recurrent/progressive disease in the thyroid bed.

The kinase inhibitors sorafenib (Nexavar) and lenvatinib (Lenvima) have significantly altered the treatment paradigm for patients with advanced radioactive iodine (RAI)-refractory differentiated thyroid cancer in both older and younger populations, with combination strategies hoping to further build upon this success.

Dr. Sylvia Asa, MD, PhD, pathologist with the Toronto General Hospital/Research Institute (UHN) and a professor at the University of Toronto, discusses genotyping and the role it can play in diagnosing and selecting targeted treatments for thyroid cancer.