Anaplastic thyroid cancer

Anaplastic thyroid cancer is an uncommon, typically lethal malignancy of older adults with no effective systemic therapy. The mean survival time is usually less than 6 months from the time of diagnosis and, unfortunately, this outcome is not fundamentally altered by available treatments. Histologic tissue confirmation is recommended if the diagnosis is not absolutely certain to exclude tumors with better prognosis or that require different treatment. Patency of the airway should be kept in mind throughout the patient's course and individuals with impending airway obstruction, in the absence of imminent death from other sites of disease, should be considered for a tracheostomy to secure the airway. Enrollment in meaningful clinical trials should be given the highest priority at all decision points.

Medullary thyroid cancer treated by capecitabine

Medullary thyroid carcinoma with distant metastases is generally incurable, with 20% overall survival at 10 years. The treatment goal is palliative. Chemotherapy has a limited role, with low response rates and high toxicities with the different regimens. Here, we report the case of 64-year-old man with metastatic medullary thyroid carcinoma in progression after primary treatment with cisplatin-doxorubicin. The patient received capecitabine 2000 mg/m total per day x 14 days followed by 1-week rest. He received 41 cycles, and presented prolonged and objective tumor response (30 months), without any toxicity.