title: Sorafenib induced thyroiditis in two patients with hepatocellular carcinoma.
abstract: BACKGROUND
  Sorafenib is a multi-targeted tyrosine kinase inhibitor licensed for the treatment of hepatocellular carcinoma and renal cell carcinoma. Thyroid function test abnormalities have been reported for different tyrosine kinase inhibitors, but only limited data on thyroid function test abnormalities related to sorafenib are available, demonstrating the occurrence of hypothyroidism in patients treated with sorafenib.
  
  
  CONCLUSIONS
  We describe two patients who developed temporary hyperthyroidism during the course of sorafenib treatment, which was followed by overt and subclinical hypothyroidism, respectively. Thyroid ultrasonography showed an atrophic thyroid gland in patient 1 , and signs of thyroiditis in patient 2 . Detailed reassessment of thyroid volumes on routinely performed computerized tomography scans showed a gradual decrease in thyroid volume during sorafenib treatment in one patient, suggesting progressive thyroid destruction.
  
  
  CONCLUSIONS
  This case report describes in detail and for the first time two cases of sorafenib-induced thyroiditis. We assume that this sorafenib-induced destructive thyroiditis is an important cause of sorafenib-induced hypothyroidism.
authors.affiliation: Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Leni
authors.initials: L
authors.lastname: van Doorn
authors.forename: Ferry A L M
authors.initials: FA
authors.lastname: Eskens
authors.forename: Theo J
authors.initials: TJ
authors.lastname: Visser
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.forename: Ron H J
authors.initials: RH
authors.lastname: Mathijssen
authors.forename: Robin P
authors.initials: RP
authors.lastname: Peeters
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001284:Atrophy; D001557:Benzenesulfonates / Q000009:adverse effects* / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000009:adverse effects* / Q000627:therapeutic use*; D000077157:Sorafenib; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D013966:Thyroiditis / Q000139:chemically induced* / Q000175:diagnosis; D014463:Ultrasonography
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib