{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:14:00Z","timestamp":1774311240242,"version":"3.50.1"},"reference-count":8,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Eine 75-j\u00e4hrige Patientin stellte sich mit Reizhusten und Belastungsdyspnoe vor. Die initiale CT-Diagnostik zeigte eine ausgedehnte mediastinale Lymphadenopathie bei suspektem rechtsseitigem Schilddr\u00fcsenknoten und beidseitigen Halslymphknoten.<\/jats:p>\n                  <jats:p>Punktionszytologisch wurde ein follikul\u00e4res Schilddr\u00fcsenkarzinom mit zervikaler lymphogener Metastasierung diagnostiziert. Eine molekulargenetische Analyse ergab keine targetierbaren Mutationen. Das FDG-PET-CT best\u00e4tigte multiple mediastinale und bihil\u00e4re Lymphknotenmetastasen sowie eine kleine oss\u00e4re Metastase im Os ilium.<\/jats:p>\n                  <jats:p>Fortgeschrittenes, mediastinal lymphogen metastasiertes follikul\u00e4res Schilddr\u00fcsenkarzinom ohne kurativen Therapieansatz.<\/jats:p>\n                  <jats:p>Nach interdisziplin\u00e4rer Tumorkonferenz wurde eine palliativ intendierte Therapie mit dem Tyrosinkinaseinhibitor (TKI) Lenvatinib begonnen. Nach achtmonatiger Behandlung zeigte sich eine deutliche Reduktion der mediastinalen Tumormasse, wodurch eine totale Thyreoidektomie mit Lymphadenektomie durchgef\u00fchrt werden konnte. Anschlie\u00dfend erfolgte eine adjuvante Radiojodtherapie (5,5 GBq I-131). Histologisch zeigte sich ein anaplastisches Schilddr\u00fcsenkarzinom mit partieller plattenepithelialer Differenzierung. Sechs Monate postoperativ wurde bei Progression der Metastasen eine Kombinationstherapie mit Lenvatinib und Pembrolizumab begonnen. Unter dieser Therapie ist die Patientin derzeit in stabilem Allgemeinzustand.<\/jats:p>\n                  <jats:p>In ausgew\u00e4hlten F\u00e4llen kann eine initial palliativ intendierte Therapie mit einem TKI ein neoadjuvantes Behandlungsergebnis erm\u00f6glichen und somit einen kurativen Ansatz er\u00f6ffnen. Voraussetzung ist eine enge multidisziplin\u00e4re Betreuung und regelm\u00e4\u00dfige Verlaufskontrolle.<\/jats:p>","DOI":"10.1055\/a-2771-0982","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T23:30:25Z","timestamp":1774308625000},"page":"320-325","source":"Crossref","is-referenced-by-count":0,"title":["Palliativ initiierte und sp\u00e4ter auf neoadjuvant umgestellte Therapie bei fortgeschrittenem, ausgedehnt mediastinal lymphogen metastasiertem, follikul\u00e4ren Schilddr\u00fcsenkarzinom  \u2013 ein Fallbericht"],"prefix":"10.1055","volume":"151","author":[{"given":"Constantin","family":"Smaxwil","sequence":"additional","affiliation":[{"name":"Endokrine Chirurgie, Diakonie-Klinikum Stuttgart, Stuttgart, GERMANY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Valina","sequence":"additional","affiliation":[{"name":"Endokrine Chirurgie, Endokrines Zentrum Stuttgart, Diakonie-Klinikum Stuttgart,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moritz","family":"Senne","sequence":"additional","affiliation":[{"name":"Allgemeine, Viszeral- und Transplantationschirurgie, Universit\u00e4tsklinik T\u00fcbingen,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Aschoff","sequence":"additional","affiliation":[{"name":"Nuklearmedizin, Diakonie-Klinikum Stuttgart,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Rischpler","sequence":"additional","affiliation":[{"name":"Nuklearmedizin, Klinikum Stuttgart,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Winter-Emden","sequence":"additional","affiliation":[{"name":"Onkologie, Diakonie-Klinikum Stuttgart,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Klasen","sequence":"additional","affiliation":[{"name":"Endokrinologie, Endokrines Zentrum Stuttgart, Diakonie-Klinikum Stuttgart,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Zielke","sequence":"additional","affiliation":[{"name":"Endokrine Chirurgie, Endokrines Zentrum Stuttgart, Diakonie-Klinikum Stuttgart,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"15077","DOI":"10.1038\/nrdp.2015.77","article-title":"Follicular cell-derived thyroid cancer","volume":"1","author":"H Dralle","year":"2015","journal-title":"Nat Rev Dis Primers"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2024.08.046","article-title":"Neoadjuvant systemic therapy for inoperable differentiated thyroid cancers: Impact on tumor resectability","author":"K Dickerson","year":"2024","journal-title":"Surgery"},{"issue":"10","key":"ref3","doi-asserted-by":"publisher","first-page":"2496","DOI":"10.1002\/hed.27735","article-title":"Neoadjuvant therapy to improve resectability of advanced thyroid cancer: A real-world experience, Multicenter Study","volume":"46","author":"M Russell","year":"2024","journal-title":"Epub"},{"issue":"07","key":"ref4","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1089\/thy.2020.0322.","article-title":"Combination of Lenvatinib and Pembrolizumab Is an Effective Treatment Option for Anaplastic and Poorly Differentiated Thyroid Carcinoma","volume":"31","author":"C Dierks","year":"2021","journal-title":"Thyroid"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1016\/j.semcancer.2020.11.013.","article-title":"Molecular targets of tyrosine kinase inhibitors in thyroid cancer","volume":"79","author":"P Fallahi","year":"2022","journal-title":"Semin Cancer Biol"},{"issue":"03","key":"ref6","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1016\/j.beem.2017.04.012","article-title":"Management of tyrosine kinase inhibitors (TKI) side effects in differentiated and medullary thyroid cancer patients","volume":"31","author":"C Resteghini","year":"2017","journal-title":"Review Best Pract Res Clin Endocrinol Metab"},{"issue":"07","key":"ref7","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1200\/OP.24.00283","article-title":"Multidisciplinary Management of Advanced Thyroid Cancer","volume":"20","author":"JY Bruce","year":"2024","journal-title":"JCO Oncol Pract"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1530\/ETJ-24-0371","article-title":"Personalized treatment of 95 poorly differentiated thyroid cancer\/anaplastic thyroid cancer in 2019\u20132023","author":"NS Huang","year":"2025","journal-title":"Eur Thyroid J"}],"container-title":["DMW - 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