title: Oncocytic, focally anaplastic, thyroid cancer responding to erlotinib.
abstract: OBJECTIVE
  To highlight the molecular findings and clinical response of a patient with rapidly progressing, focally anaplastic, oncocytic thyroid carcinoma (OTC) treated with erlotinib.Case Summary. A 69-year-old woman with recurrent, focally anaplastic OTC was given a therapeutic trial of erlotinib, a small molecule inhibitor of epidermal growth factor receptor (EGFR). Formalin-fixed, paraffin-embedded portions of the tumor were analyzed for EGFR expression, and tumor genomic DNA was amplified by polymerase chain reaction (PCR) and subjected to EGFR mutation analysis.Discussion. An early and dramatic response was achieved with erlotinib. The tumor was focally positive for EGFR by immunostaining and two point mutations were identified, one on exon 18 and one on exon 20 in the tyrosine kinase (TK) domain.
  
  
  CONCLUSIONS
  Erlotinib or other novel protein kinase pathway inhibitors should be evaluated further in patients with aggressive thyroid cancer variants, who may exhibit these and perhaps other tyrosine kinase mutations.
authors.affiliation: Department of Medicine, Robert C. Byrd Health Sciences Center & Mary Babb Randolph Cancer Center, West Virginia University, POB 9162 Morgantown, WV 26506-9162, USA. thogan@hsc.wvu.edu
authors.forename: Thomas
authors.initials: T
authors.lastname: Hogan
authors.lastname: Jing Jie Yu
authors.forename: H James
authors.initials: HJ
authors.lastname: Williams
authors.forename: Ramin
authors.initials: R
authors.lastname: Altaha
authors.lastname: Xiaobing Liang
authors.lastname: Qi He
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics / Q000378:metabolism; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D017354:Point Mutation; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D011799:Quinazolines / Q000627:therapeutic use*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D014057:Tomography, X-Ray Computed
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; C512478:EGFR protein, human; D066246:ErbB Receptors