PMC5651555_01
A computed tomography examination revealed a mass, measuring 18 x 17 mm in the upper right lobe of thyroid (A) and swollen lymph nodes in neck: the lymph node at the right upper neck suspected invasion of right internal jugular vein (B), the left paratracheal lymph node suspected invasion of cervical esophagus and trachea (C). Bronchoscope examination revealed tumor invasion in tracheal lumen (D).
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The left paratracheal lymph node, measuring 30 x 25 mm was suspected to have invaded the cervical esophagus and trachea (Fig. 1A-C). A bronchoscopy revealed a tumor invasion in the tracheal lumen (Fig. 1D).
A computed tomography examination showed tumor reduction: (A) lymph node at the right neck decreased in size by 84.3%, (B) left parabronchial lymph node decreased in size by 56.0%, and (C) thyroid tumor decreased in size by 5.9%. (i) before treatment, (ii) after treatment.
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After administration of lenvatinib (total dose, 966 mg for 22 weeks; including total of 4 weeks of withdrawal during the administration period), the tumor decreased in size by 84.3%, the cervical lymph nodes by 56.0% (Fig. 2A, B), and the thyroid papillary carcinoma by 5.9% (Fig. 2C).
After lenvatinib therapy, a bronchoscopy showed a residual tumor in the tracheal lumen, but tumor was reduced.
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Bronchoscopy showed a residual tumor in the tracheal lumen; however, the tumor was reduced (Fig. 3).