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

• DOI: 10.1159/000366192
• Publication Date: 2017-04-18T21:47:07Z
• Authors: Gema Bruixola; Ángel Segura; Javier Caballero; Ana Andrés; Encarnación Reche; Corina Escoín; Roberto Díaz-Beve...
• Keywords: Lenvatinib

<b><i>Background:</i></b> Cardiac metastases from papillary thyroid carcinoma are very uncommon. Their incidence is rising due to improvements in survival and diagnosis; nevertheless, our patient the fourth case reported up date. There no clinical trials available this scenario. Therefore, treatment choice made based on experience reports; notably, largest report series was prior approval for using tyrosine-kinase inhibitors cancer. <b><i>Patient:</i></b> A 73-year-old lady had dedifferentiated cancer with ongoing sorafenib. After 9 months treatment, she presented dyspnea heart failure. Differential diagnosis included infection, progression of disease cardiotoxicity. a comprehensive assessment (echocardiography, computed tomography, PET, magnetic resonance), we found lung disease, appearance metastases. <b><i>Results:</i></b> recovering basal status, started second-line sunitinib, which well-tolerated. She achieved stable decrease tumor marker levels. <b><i>Conclusions:</i></b> We should include cardiac differential failure patients. Magnetic resonance imaging gold standard assessment. Sorafenib mainstay first-line therapy metastatic cancer, achieving long-term control good tolerance. Sunitinib could be safe option (not cardiotoxicity related) promising results. presents sequence an encouraging outcome, deserves further investigation.