Medullary thyroid carcinoma and somatostatin analogues, a possible therapeutic choice in asymptomatic and slow radiological progression metastatic recurrent disease after surgery – Case report of a 22-years long term survival patient

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Introduction: Medullary thyroid carcinoma (MTC) is a well-differentiated neuroendocrine tumor of the thyroid and accounts for 1%-2% of thyroid cancers in the United States. MTCs present with locoregional metastasis in 50% of patients and distant metastasis in 10%-15% at diagnosis. Treatment options for recurrent or progressive disease according to RECIST 1.1 criteria, are limited. Tyrosine kinase-inhibitors (TKI) are preferred as first-line systemic therapy. Although somatostatin analogues (SSA) may play a role in MTC, limited evidence is available.

Aim(s): We present the case of a 72-year-old woman, who underwent total thyroidectomy for multinodular goiter in 2000 with histologic diagnosis of MTC, RET-wild type.

Materials and methods: After surgery the patient showed an incomplete biochemical response but remained symptom-free for the following years. Since 2005 she was treated with lanreotide autogel 120 mg/every 28 days. In 2014 lanreotide autogel was administered with high frequency (every 14 days) for radiological progression. The use of SSA instead of TKI was preferred in light of the symptom-free clinical condition. In 2022 the patient developed a histologically proven secondary MTC pancreatic metastasis, making the seventh of such cases reported in the literature.

Conference:

Presenting Author: Raia S

Authors: Raia S, Chiloiro S, Maratta M, Giampietro A, de Marinis L,

Keywords: medullary thyroid carcinoma (MTC), somatostatin analogues, survival,