• Sina Cai, Huan Deng, Yinkui Chen, Xing Wu, and Xiaoqian Guan.
• Department of Oncology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
• Medicine (Baltimore). 2017 Dec 1; 96 (50): e8704e8704.

RationaleMedullary thyroid carcinoma (MTC) is a rare type thyroid carcinoma originating from the thyroid parafollicular cells (C cells). Chemotherapy has a limited efficacy for treating persistent or recurrent MTC.Patient ConcernsA 46-year-old woman who underwent thyroidectomy for MTC in December 2007. She began experience recurring diarrhea in January 2015 and started to cough and feel shortness of breath in March 2016.DiagnosesA chestcomputed tomography (CT) scan showed metastases in the bilateral lungs, pulmonary hilum, and mediastinal lymph nodes. Percutaneous biopsy of the pulmonary occupying lesions performed on March 21, 2016 indicated medullary carcinoma metastases at the right pulmonary hilum.InterventionsThis patient was treated with oral apatinib (500 mg daily).OutcomesThe patient's symptoms of diarrhea, coughing, and shortness of breath disappeared. CT reexaminations for efficacy assessment at 1, 2, and 3 months after the treatment indicated partial remission. Systemic migrating bone and joint pains occurred during the treatment, which were considered to be adverse events of apatinib.LessonsTreatment of MTC with apatinib has been shown to be effective in our case. Tyrosine kinase inhibitors (TKIs) that suppress rearranged during transfection (RET) and vascular endothelial growth factor receptor (VEGFR) should be considered as a effective therapeutic approaches.Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

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