The female ATC patient was 78 years old....Immunohistochemistry and molecular testing analysis of the tumor showed the tumor proportion score of programmed death-ligand 1 <1% (PD-L1-negative), tumor mutation burden of 1.88 mut/Mb (TMB-low)...anti-angiogenic agent anlotinib orally 12 mg per day and 2-week on/1-week off; and the immunotherapeutic agent, sintilimab, administrated with 200 mg once every 3 weeks. 2.5 months after the treatment, the recurrent tumor was reduced to 2.5 cm × 1.8 cm, and no lesions were found in the lung and colons.