Int J Thyroidol.  2018 Nov;11(2):75-77. 10.11106/ijt.2018.11.2.75.

Management of Severe Fatigue Induced by Tyrosine Kinase Inhibitor in Radioiodine Refractory Thyroid Cancer

• Ahn BC

• KMID: 2448974
• DOI: http://doi.org/10.11106/ijt.2018.11.2.75

Abstract

Tyrosine kinase inhibitor is known to prolong progression free survival in radioiodine refractory thyroid cancer patients. Fatigue/asthenia/malaise is one of most common adverse events by the tyrosine kinase inhibitor treatment, and management of the adverse event is important to keep the drug medication longer which is essential for the survival benefit. In the case report, a radioiodine refractory thyroid cancer patient receiving tyrosine kinase inhibitor experienced severe fatigue, and a pathologic fracture of right humerus occurred by slipping down which was tightly linked with the adverse event of the drug. The pathologic fracture was surgically well managed and the adverse event was well controlled by supportive managements combined with dose reduction of the tyrosine kinase inhibitor. The drug administration to the patient was kept more than 1 year without progression of the disease.

Keyword

Radioiodine refractory thyroid cancer; Tyrosine kinase inhibitor; Adverse events; Fatigue

MeSH Terms

Disease-Free Survival
Fatigue*
Fractures, Spontaneous
Humans
Humerus
Protein-Tyrosine Kinases*
Thyroid Gland*
Thyroid Neoplasms*
Tyrosine*
Protein-Tyrosine Kinases
Tyrosine

Figure

• 

  Fig. 1 F-18 FDG PET obtained at just before lenvatinib treatment revealed multiple hypermetabolic lesions at chest, abdomen and extremities due to lung and osseous metastases. Arrow indicates a bone metastatic lesion at right humerus.

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  Fig. 2 (A) Pathologic fracture of right humerus by slip down. (B) Open reduction and internal fixation of right humerus with intramedullary rod.

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