Anaplastic Thyroid Carcinoma With Horner Syndrome and Unusual Metastasis Reveals Masked Papillary Thyroid Carcinoma Following Neoadjuvant Therapy
Year: 2025
Type: article
Study design: Case Report
Abstract: Anaplastic thyroid carcinoma is a rare thyroid cancer that has the propensity to be hyperactive and is characterized by the dedifferentiation of follicular cells leading to pleomorphism. This report highlights a 68-year-old male’s progression of anaplastic thyroid carcinoma with an unusual presentation and secondary symptoms revealed to be masking an independent tumor cell origin residual papillary thyroid carcinoma following targeted treatment. A 68-year-old male presenting with a history of aortic aneurysm and hyperlipidemia was referred for type 2 diabetes mellitus complications. He had a successful aneurysm repair, but follow-up imaging revealed a thyroid mass, cystic lesions in the pancreas and liver, extensive lymphadenopathy, and he endorsed symptoms of Horner’s Syndrome. Fine-needle aspiration suggested anaplastic thyroid carcinoma, and sequencing confirmed a BRAF V600E mutation. He began neoadjuvant BRAF/MEK inhibitor therapy to shrink the tumor and resolve metastasis. After a right thyroid lobectomy, pathology revealed a hidden non- BRAF mutated-papillary thyroid carcinoma. He is currently under multidisciplinary care and being considered for total thyroidectomy. Normally, comorbid thyroid malignancies arise from identical follicular mutations. It is unusual to observe two independent origins from comorbid thyroid cancers. Also, the development of Horner Syndrome from thyroid cancer, especially anaplastic, is incredibly rare. Conclusion : This case is a unique depiction of how anaplastic thyroid carcinoma can present despite uncharacteristic immunohistochemical markers, secondary symptoms, and hidden comorbidities. As an understudied malignancy, it is important to recognize this condition’s variability to prevent increased mortality and morbidity. • Papillary thyroid carcinoma (PTC) is generally masked by anaplastic thyroid carcinoma (ATC) • PTC can persist despite treatment if mutation burden is different than ATC • Horner syndrome is a rare complication of ATC prior to thyroidectomy • Liver and pancreas metastasis is rarely seen in ATC
Source: AACE Endocrinology and Diabetes
Authors: Zain Akhtar, Humberto López Castillo, Deepa Taneja
Institution: University of Central Florida
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4415422744