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V600E BRAF-mutated anaplastic thyroid carcinoma after radioactive iodine for Graves’ disease: a case report and a review of the literature

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Abstract

Introduction

Radioactive iodine (RAI) therapy is part of the treatment option for Graves’ disease, and it is widely accepted to be safe. However, some evidence suggests its association to a small increased risk of thyroid cancer and rarely to an aggressive form of thyroid carcinoma.

Case report

Here, we report a case of anaplastic thyroid carcinoma (ATC) following RAI treatment for Graves’ disease. A 48 year-old woman had been diagnosed with Graves’ disease and thyroid nodules. A single RAI treatment had been performed after an unsuccessful medical therapy approach. More than 10 years later, the patient was admitted to our clinic due to dysphonia, weight loss and a rapidly growing neck mass. Thyroid ultrasound and neck computed tomography suggested a thyroid carcinoma and she was diagnosed with a V600E BRAF-mutated ATC. She was given carboplatin, paclitaxel, and radiotherapy. The patient died a few months after the first symptoms of the disease occurred.

Discussion

It is not clear if the occurrence of ATC could be influenced by the RAI therapy for hyperthyroidism. Therefore, we reviewed the different cases and characteristics of ATC after RAI published so far in the literature. Patients were exclusively females, the median age at diagnosis was 66,5 years old (IQR: 51,5–69, range 29–75) and the median time occurring from RAI treatment and ATC diagnosis was 7 years. To our knowledge, here we report the first patient with V600E BRAF-mutation in ATC after RAI for Graves’ disease.

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All authors had full access to all the data in the study and take responsibility for the integrity of the data.

References

  1. Kahaly GJ, Bartalena L, Hegedüs L et al (2018) European thyroid association guideline for the management of Graves’ hyperthyroidism. Eur Thyroid J 7:167–186

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Dobyns BM, Sheline GE, Workman JB et al (1974) Malignant and benign neoplasms of the thyroid in patients treated for hyperthyroidism: a report of the cooperative thyrotoxicosis therapy follow-up study. J Clin Endocrinol Metab 38:976–998

    Article  CAS  PubMed  Google Scholar 

  3. Ron E, Doody MM, Becker DV et al (1998) Cancer mortality following treatment for adult hyperthyroidism. JAMA 280:347–355

    Article  CAS  PubMed  Google Scholar 

  4. Hall P, Berg G, Bjelkengren G et al (1992) Cancer mortality after iodine-131 therapy for hyperthyroidism. Int J Cancer 50:886–890

    Article  CAS  PubMed  Google Scholar 

  5. Franklyn JA, Maisonneuve P, Sheppard M et al (1999) Cancer incidence and mortality after radioiodine treatment for hyperthyroidism: a population-based cohort study. Lancet (London, England) 353:2111–2115

    Article  CAS  PubMed  Google Scholar 

  6. Metso S, Auvinen A, Huhtala H et al (2007) Increased cancer incidence after radioiodine treatment for hyperthyroidism. Cancer 109:1972–1979

    Article  CAS  PubMed  Google Scholar 

  7. Gronich N, Lavi I, Rennert G et al (2020) Cancer risk after radioactive iodine treatment for hyperthyroidism: a cohort study. Thyroid 30(2):243–250

    Article  CAS  PubMed  Google Scholar 

  8. Kitahara CM, Berrington De Gonzalez A, Bouville A et al (2019) association of radioactive iodine treatment with cancer mortality in patients with hyperthyroidism. JAMA Intern Med 179:1034–1042

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hoffman DA, McConahey WM, Fraumeni JFJ et al (1982) Cancer incidence following treatment of hyperthyroidism. Int J Epidemiol 11:218–224

    Article  CAS  PubMed  Google Scholar 

  10. Shim SR, Kitahara CM, Cha ES et al (2021) Cancer risk after radioactive iodine treatment for hyperthyroidism: a systematic review and meta-analysis. JAMA Netw Open 4:1–14

    Article  Google Scholar 

  11. Williams ED (1986) Relation between 131I therapy for thyrotoxicosis and development of thyroid carcinoma. Lancet. https://doi.org/10.1016/S0140-6736(86)92159-8

    Article  PubMed  Google Scholar 

  12. Remick SC, Nagaiah G, Hossain A et al (2011) Anaplastic thyroid cancer: a review of epidemiology, pathogenesis, and treatment. J Oncol. https://doi.org/10.1155/2011/542358

    Article  PubMed  PubMed Central  Google Scholar 

  13. Scheffel RS, Dora JM, Maia AL (2022) BRAF mutations in thyroid cancer. Curr Opin Oncol 34:9–18

    Article  CAS  PubMed  Google Scholar 

  14. Bible KC, Kebebew E, Brierley J et al (2021) American thyroid association guidelines for management of patients with anaplastic thyroid cancer. Thyroid 31:337–386

    Article  PubMed  PubMed Central  Google Scholar 

  15. Riley AS, McKenzie GAG, Green V et al (2019) The effect of radioiodine treatment on the diseased thyroid gland. Int J Radiat Biol. https://doi.org/10.1080/09553002.2019.1665206

    Article  PubMed  Google Scholar 

  16. Ryödi E, Metso S, Jaatinen P et al (2015) Cancer incidence and mortality in patients treated either with RAI or thyroidectomy for hyperthyroidism. J Clin Endocrinol Metab 100:3710–3717

    Article  PubMed  Google Scholar 

  17. Campennì A, Avram AM, Verburg FA et al (2023) The EANM guideline on radioiodine therapy of benign thyroid disease. Eur J Nucl Med Mol Imaging. https://doi.org/10.1007/s00259-023-06274-5

    Article  PubMed  PubMed Central  Google Scholar 

  18. Russ G, Bonnema SJ, Erdogan MF et al (2017) European thyroid association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: the EU-TIRADS. Eur Thyroid J 6:225–237

    Article  PubMed  PubMed Central  Google Scholar 

  19. Narendran N, Luzhna L, Kovalchuk O (2019) Sex difference of radiation response in occupational and accidental exposure. Front Genet 10:1–11

    Article  Google Scholar 

  20. Saenko V (2023) Radiation-related thyroid cancer. Endocr Rev 45(1):1–29

    Article  PubMed Central  Google Scholar 

  21. Rivkees SA (2016) Controversies in the management of Graves’ disease in children. J Endocrinol Invest 39:1247–1257

    Article  CAS  PubMed  Google Scholar 

  22. Baker HW (1969) Anaplastic thyroid cancer twelve years after radioiodine therapy. Cancer 23:885–890

    Article  CAS  PubMed  Google Scholar 

  23. Gossage AA, Neal FE, Ross CM et al (1984) Cases of carcinoma of thyroid following iodine-131 therapy for hyperthyroidism. Oncology 41:8–12

    Article  CAS  PubMed  Google Scholar 

  24. Kim SH, Kim HY, Jung KY et al (2013) Anaplastic thyroid carcinoma following radioactive iodine therapy for graves’ disease. Endocrinol Metab 28:61

    Article  Google Scholar 

  25. Al Eyadeh A, Al-Sarihin K, Etewi S et al (2017) Thyroid cancer post radioactive iodine treatment for hyperthyroidism—case series and review of the literature. Endokrynol Pol 68:561–566

    Article  PubMed  Google Scholar 

  26. Fujikawa M, Okamura K, Sato K et al (1998) Anaplastic transformation of a papillary carcinoma of the thyroid in a patient with Graves’ disease with varied activity of thyrotropin receptor antibodies. Thyroid 8:53–58

    Article  CAS  PubMed  Google Scholar 

  27. Pazaitou-Panayiotou K, Michalakis K, Paschke R (2012) Thyroid cancer in patients with hyperthyroidism. Horm Metab Res Ger 44:255–262

    Article  CAS  Google Scholar 

  28. Belfiore A, Russo D, Vigneri R et al (2001) Graves’ disease, thyroid nodules and thyroid cancer. Clin Endocrinol (Oxf) 55:711–718

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

Authors

Contributions

All the authors contributed to the study conception and design. Villanova M performed the literature search and data analyses, and drafted the first version of the manuscript. Giubbini R performed data analyses, and critically revised the work for important intellectual content. Di Filippo L and Castellino L aided with interpretation of data and provided substantial contribution to patient’s data. Bolamperti FM provided substantial contribution to patient’s data and Rodella C performed data analyses. All authors revised and approved the final version to be published.

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Correspondence to Marta Villanova.

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Villanova, M., di Filippo, L., Bolamperti, F.M. et al. V600E BRAF-mutated anaplastic thyroid carcinoma after radioactive iodine for Graves’ disease: a case report and a review of the literature. Clin Transl Imaging (2024). https://doi.org/10.1007/s40336-024-00643-2

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