{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T13:51:59Z","timestamp":1745934719086,"version":"3.37.3"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T00:00:00Z","timestamp":1724025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T00:00:00Z","timestamp":1724025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Papillary thyroid carcinoma rarely undergoes anaplastic transformation. Some risk factors for anaplastic transformation of thyroid cancer are known, but such transformation is difficult to predict in practice. We report a case demonstrating elevations of neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) over time as a precursor to anaplastic transformation of thyroid carcinoma.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>The patient was an 89\u00a0year-old woman with a history of chronic aortic dissection. She was referred to our department after her local doctor detected thyroid nodules. She had previously been found to have multinodular goiter and enlarged left cervical lymph nodes on computed tomography. Her chief complaint was cervical discomfort and hoarseness. Blood tests revealed: white blood cells (WBCs), 4900\u00a0\/\u00b5L; CRP, 0.29\u00a0mg\/dL; neutrophils, 64.4%; and lymphocytes, 25.4%. A 21\u00a0mm mass was identified in the upper left lobe. Left III (16\u00a0mm) and left VI (16\u00a0mm) lymph node were enlarged on ultrasonography. Fine-needle aspiration cytology diagnosed malignant papillary carcinoma. However, due to the advanced age and medical history of the patient, a non-surgical policy was implemented. The primary tumor grew to 4\u00a0cm in diameter by 9\u00a0months after diagnosis, and blood tests showed: WBC, 7700\u00a0\/\u00b5L; CRP, 0.18\u00a0mg\/dL; neutrophils, 65.3%; and lymphocytes, 22.3%. By 10\u00a0months after diagnosis, the tumor had increased rapidly in diameter to 8\u00a0cm, with blood tests showing: WBC, 6500\u00a0\/\u00b5L; CRP, 1.01\u00a0mg\/dL; neutrophils, 68.2%; and lymphocytes, 19.3%. Anaplastic transformation of papillary thyroid carcinoma was diagnosed, and the patient was placed on treatment under a policy of best supportive care. Multiple lung metastases appeared 11\u00a0months after diagnosis, and blood test results showed: WBC, 13,300\u00a0\/\u03bcL; CRP, 11.28\u00a0mg\/dL; neutrophils, 93.6%; and lymphocytes, 2.3%. Unfortunately, the patient died of disease progression 63\u00a0days after identification of undifferentiated metastasis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Chances to see the natural history of anaplastic transformation of thyroid cancer are rare. Elevations in NLR and CRP over time may be precursors to anaplastic transformation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-024-01991-x","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T07:02:17Z","timestamp":1724050937000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Elevations of neutrophil-to-lymphocyte ratio and C-reactive protein over time as a precursor to anaplastic transformation of papillary thyroid carcinoma: a case report"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6419-7645","authenticated-orcid":false,"given":"Masaomi","family":"Sen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Ito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Abe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroko","family":"Kazusaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mami","family":"Matsui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Saitou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuta","family":"Nagaoka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoo","family":"Jikuzono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iwao","family":"Sugitani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,19]]},"reference":[{"issue":"3","key":"1991_CR1","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1089\/thy.2020.0944","volume":"31","author":"KC Bible","year":"2021","unstructured":"Bible KC, Kebebew E, Brierley J, Brito JP, Cabanillas ME, Clark TJ Jr, et al. 2021 American thyroid association guidelines for management of patients with anaplastic thyroid cancer. Thyroid. 2021;31(3):337\u201386.","journal-title":"Thyroid"},{"key":"1991_CR2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.948033","volume":"12","author":"G Graceffa","year":"2022","unstructured":"Graceffa G, Salamone G, Contino S, Saputo F, Corigliano A, Melfa G, et al. Risk factors for anaplastic thyroid carcinoma: a case series from a tertiary referral center for thyroid surgery and literature analysis. Front Oncol. 2022;12: 948033.","journal-title":"Front Oncol"},{"key":"1991_CR3","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.1038\/modpathol.2017.75","volume":"30","author":"N Oishi","year":"2017","unstructured":"Oishi N, Kondo T, Ebina A, Sato Y, Akaishi J, Hino R, et al. Molecular alterations of coexisting thyroid papillary carcinoma and anaplastic carcinoma: identification of TERT mutation as an independent risk factor for transformation. Mod Pathol. 2017;30:1527\u201337.","journal-title":"Mod Pathol"},{"key":"1991_CR4","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1007\/s002680020166","volume":"25","author":"I Sugitani","year":"2001","unstructured":"Sugitani I, Kasai N, Fujimoto Y, Yanagisawa A. Prognostic factors and therapeutic strategy for anaplastic carcinoma of the thyroid. World J Surg. 2001;25:617\u201322.","journal-title":"World J Surg"},{"key":"1991_CR5","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1016\/j.surg.2011.09.005","volume":"150","author":"Y Orita","year":"2011","unstructured":"Orita Y, Sugitani I, Amemiya T, Fujimoto Y. Prospective application of our novel prognostic index in the treatment of anaplastic thyroid carcinoma. Surgery. 2011;150:1212\u20139.","journal-title":"Surgery"},{"key":"1991_CR6","first-page":"6667237","volume":"2020","author":"H Iwasaki","year":"2020","unstructured":"Iwasaki H, Toda S, Murayama D, Takahashi H. Three cases of anaplastic thyroid carcinoma transformation and leukocytosis during lenvatinib treatment. Case Rep Endocrinol. 2020;2020:6667237.","journal-title":"Case Rep Endocrinol"},{"key":"1991_CR7","doi-asserted-by":"publisher","first-page":"187","DOI":"10.4174\/astr.2015.88.4.187","volume":"88","author":"JS Cho","year":"2015","unstructured":"Cho JS, Park MH, Ryu YJ, Yoon JH. The neutrophil to lymphocyte ratio can discriminate anaplastic thyroid cancer against poorly or well differentiated cancer. Ann Surg Treat Res. 2015;88:187\u201392.","journal-title":"Ann Surg Treat Res"},{"key":"1991_CR8","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019686","volume":"99","author":"J Feng","year":"2020","unstructured":"Feng J, Wang Y, Shan G, Gao L. Clinical and prognostic value of neutrophil-lymphocyte ratio for patients with thyroid cancer: a meta-analysis. Medicine. 2020;99: e19686.","journal-title":"Medicine"},{"key":"1991_CR9","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s12020-020-02313-5","volume":"70","author":"H Yamazaki","year":"2020","unstructured":"Yamazaki H, Sugino K, Matsuzu K, Masaki C, Akaishi J, Hames K, et al. Inflammatory biomarkers and dynamics of neutrophil-to-lymphocyte ratio in anaplastic thyroid carcinoma. Endocrine. 2020;70:115\u201322.","journal-title":"Endocrine"},{"key":"1991_CR10","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1089\/thy.2018.0684","volume":"29","author":"J Ahn","year":"2019","unstructured":"Ahn J, Song E, Oh HS, Song DE, Kim WG, Kim TY, et al. Low lymphocyte-to-monocyte ratios are associated with poor overall survival in anaplastic thyroid carcinoma patients. Thyroid. 2019;29:824\u20139.","journal-title":"Thyroid"},{"key":"1991_CR11","doi-asserted-by":"publisher","first-page":"852","DOI":"10.21037\/gs-20-871","volume":"10","author":"H Yamazaki","year":"2021","unstructured":"Yamazaki H, Iwasaki H, Suganuma N, Toda S, Masudo K, Nakayama H, et al. Inflammatory biomarkers and dynamics of neutrophil-to-lymphocyte ratio in lenvatinib treatment for anaplastic thyroid carcinoma. Gland Surg. 2021;10:852\u201360.","journal-title":"Gland Surg"},{"key":"1991_CR12","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1002\/jso.23753","volume":"110","author":"M Ishizuka","year":"2014","unstructured":"Ishizuka M, Oyama Y, Abe A, Kubota K. Combination of platelet count and neutrophil to lymphocyte ratio is a useful predictor of postoperative survival in patients undergoing surgery for gastric cancer. J Surg Oncol. 2014;110:935\u201341.","journal-title":"J Surg Oncol"},{"key":"1991_CR13","first-page":"52","volume":"17","author":"G Kasymjanova","year":"2010","unstructured":"Kasymjanova G, MacDonald N, Agulnik JS, Cohen V, Pepe C, Kreisman H, et al. The predictive value of pre-treatment inflammatory markers in advanced non-small-cell lung cancer. Curr Oncol. 2010;17:52\u20138.","journal-title":"Curr Oncol"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-024-01991-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-024-01991-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-024-01991-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T19:06:23Z","timestamp":1724094383000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-024-01991-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,19]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1991"],"URL":"https:\/\/doi.org\/10.1186\/s40792-024-01991-x","relation":{},"ISSN":["2198-7793"],"issn-type":[{"type":"electronic","value":"2198-7793"}],"subject":[],"published":{"date-parts":[[2024,8,19]]},"assertion":[{"value":"13 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication of this case report was obtained from the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no competing interests to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"190"}}