Successful Reinduction Therapy by Sorafenibin Oncocytic Follicular Thyroid Cancer: a Case Report

Introduction: Patients with iodine-refractory, locally advanced or metastatic differentiated thyroid cancer usually have a poor prognosis. As new therapeutic options, tyrosine kinase inhibitors may slow down progression and stabilize the disease. The resumption of therapy after progression of the disease is questionable. Presentation of case: We report a case of a 68 year-old woman diagnosed with oncocytic follicular thyroid cancer with disease duration of 15 years. She was treated by bilateral subtotal thyroid resection, total thyroidectomy, three high-dose radioiodine treatments and two irradiation therapies. Sorafenib therapy was started in February, 2012, due to disease progression with lymph node and pulmonary metastases. The disease was stabilized for 20 months and then progression in the metastatic cervical lymph nodes was detected with rapid elevation of thyroglobulin level. After the surgical removal of lymph nodes, the sorafenib therapy was reintroduced in July, 2014 and the treatment has been effective until today. Discussion: In this patient with a radioiodine-refractory, poor-risk oncocytic follicular thyroid cancer, the sorafenib therapy resulted in stable disease for 20 months and after progression and repeated surgical intervention the reinduction therapy was effective. Conclusion: Sorafenib may be a useful therapeutic possibility in the management of oncocytic follicular thyroid cancer with distant metastases. If the tumor mass can be reduced by surgical intervention, reinduction therapy with sorafenib should be considered.