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RationaleThe case reported the rapid remission of disease recurrence achieved adding foscarnet, a DNA polymerase inhibitor that interacts with fibroblast growth factor 2, to low molecular weight heparin and sunitinib for the first time in a patient with an anaplastic thyroid cancer (ATC).Patient concernsA 65-year-old woman with a multinodular goiter referred for a rapid enlargement of a nodule. Histological examination revealed an ATC with a little area of papillary thyroid cancer (PTC). The patient was resistant to selective single-target treatment.DiagnosesImmunophenotyping and gene analyses found a significant increase in FGF2 and FGFR1 expression in the primary ATC area (FGF2 = 38.2 ± 6.2% in ATC vs 34.6 ± 6.0% in the differentiated area of PTC, P InterventionsFoscarnet was administered given the positivity for FGF2, FGFR1 and FGFR4 in ATC. Low molecular wight heparin and Sunitinib were coadministere to limiti metastatic progression and on neck tumor masse, respectively.OutcomesThe rationale for the clinical response to this innovative multitarget association with foscarnet is based on the histological and genetic finding that fibroblast growth factors and their receptor super-family are up-regulated in the primary anaplastic thyroid tumor and in the metastatic lymph node of our patient.LessonsWe propose that fibroblast growth factors and their receptor super-family play a key role as potential therapeutic targets in anaplastic thyroid cancer and the positive relevance of this suggestion for patient care, especially for an individualized management.

Original publication

DOI

10.1097/md.0000000000005621

Type

Journal article

Journal

Medicine

Publication Date

02/2017

Volume

96

Addresses

Department of Experimental Medicine Department of Internal Medicine and Clinical Specialities Department of Radiology, Anatomopathology and Oncology, Sapienza University of Rome, Rome Nuclear Medicine Unit, Department of Interventional Oncology, Azienda Ospedaliera Ospedale di Circolo di Busto Arsizio Varese, Busto Arsizio, Varese, Italy.

Keywords

Humans, Thyroid Neoplasms, Foscarnet, Fluorodeoxyglucose F18, Antineoplastic Combined Chemotherapy Protocols, Antiviral Agents, Aged, Female, Thyroid Carcinoma, Anaplastic, Positron Emission Tomography Computed Tomography