Thyroid Disease Following Irradiation for Benign Conditions

Swelstad, Jack A.; Scanlon, Edward F.; Murphy, E. Dennis; Garces, R.; Khandekar, Janardan D.

doi:10.1001/archsurg.1977.01370040032005

Cited by 35 publications

(5 citation statements)

References 3 publications

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“…Paramount among these has been the established relationship between head and neck irradiation for benign conditions and the subsequent appearance of both benign and malignant abnormalities of the thyroid gland. 5,9,21,25,29 Cases of nonthyroid neoplasia involving head and neck structures following similar treatments have been described. Salivary gland tumors occur with a greater than expected frequency after radiation exposure.…”

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confidence: 99%

Parathyroid adenomas following irradiation

Russ

Scanlon

Sener

1979

Cancer

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Parathyroid adenomas have been demonstrated to occur following external head and neck irradiation. The median latency interval is 30 years. In a series of 74 consecutive patients with histologically diagnosed parathyroid adenomas, 25% gave a history of prior radiation exposure. When compared to a matched control incidence of ?.9%, statistical significance is reached at p < 0.01. Thyroid abnormalities were present in 68% of the irradiated patients, and 30% of these were malignant. Tumors of skin, breast, and parotid gland also occurred more frequently than expected. Forty-seven percent of the irradiated group had malignant neoplasms within the radiation field. The histopathology of the radiation-associated parathyroid adenomas is similar to that seen experimentally.Cancer 43 hyperparathyroidism after irradiation have been recently r e p~r t e d .~~,~~ To determine the incidence of previous head and neck irradiation in a consecutive group of patients operated for parathyroid adenoma, a retrospective analysis was instituted. MATERIALS AND METHODSDuring the years 197 1 through January 1977, 83 patients with hypercalcemia and primary hyperparathyroidism had histologically confirmed parathyroid adenomas which were surgically removed at the Evanston and Northwestern Memorial Hospitals of the McGaw Medical Center of Northwestern University. The clinical records of all patients were reviewed, and a recall program was initiated. Those individuals who were able to be contacted were questioned in detail, regarding a prior history of external radiation exposure. The histopathologic slides of those patients with a positive history were reviewed. No patients with the multiple endocrine adenoma syndrome were included. As a control population, 101 randomly selected patients previously hospitalized at our institution during the same six-year interval and matched to the study group according to age, sex, and race, were contacted and similarly questioned. RESULTSOf the 83 patients who had a parathyroid adenoma removed for primary hyperparathyroidism during the six-year period, 74

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confidence: 99%

Parathyroid adenomas following irradiation

Russ

Scanlon

Sener

1979

Cancer

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“…In a n attempt to determine whether the thyroid scan detects carcinoma that cannot be palpated preoperatively, we compared the preoperative physical findings and scans with the surgical pathology. 8 We found that 88% of the lobes containing carcinoma were abnormal to palpation, whereas 60% of the same lobes were abnormal on the preoperative thyroid scan. Because these data leave the accuracy of thyroid isotope scans open to question, we do not routinely use them at EHITEC.…”

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confidence: 64%

Head and neck neoplasia following irradiation for benign conditions

Scanlon

Sener

1981

Head Neck

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A retrospective review of 143 patients with head or neck tumors who had received radiation therapy in the head and neck area for benign conditions during childhood or adolescence was conducted. This included an analysis of 1,080 patients from the Evanston Hospital Irradiated Thyroid Evaluation Clinic, which was established to define the relationship between irradiation and the subsequent development of thyroid neoplasia. The data support the following concepts of irradiation-induced neoplasia: (1) The thyroid, parathyroid, and salivary glands can develop benign and malignant changes after irradiation for benign conditions, with latent periods averaging about 30 years; (2) Once a glandular abnormality within the irradiated field appears, the risk of other glands in the field developing neoplastic changes is significantly increased.

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“…Irradiation is considered to cause fibrosis of soft tissue, leading to high-risk surgery (11). However, several studies of open neck surgery after ipsilateral irradiation demonstrated that the surgery was safely performed, and the complication rates were sufficiently low: 0-1.5% for RLNP, 0-2.8% for hypoparathyroidism, and 0-1.5% for postoperative hematoma (5,(12)(13)(14). Kikuchi et al reviewed 171 cases and reported that there was no significant difference in the incidence of complications between the group of patients with an irradiation history and the non-irradiation history group (15).…”

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confidence: 99%

Remote-access hemithyroidectomy in a patient with papillary thyroid cancer after ipsilateral irradiation: a case report

Ho¹,

Saito²,

Ikeda³

et al. 2022

Gland Surg

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Remote-access thyroidectomy (RAT) is becoming a more frequently used approach that can avoid scars in the neck and provide better cosmetic results than open surgery. However, there has been no surgical indication for RAT in patients who have a history of cervical treatment (surgery or irradiation), and the use of RAT has been avoided in such patients. Here, we report a case in which a remote-access endoscopic hemithyroidectomy and central lymph node dissection by the anterior chest approach was successfully performed in a patient with papillary thyroid carcinoma (a 77-year-old Japanese male) after he had undergone ipsilateral cervical radiation therapy to parotid gland cancer (mucoepidermoid carcinoma) thirteen years earlier. Regarding trocar insertion, a 30-mm skin incision was made in the left anterior chest approx. 5 cm below the clavicle. Two 5-mm trocars were inserted through the 30-mm incision. We then insufflated with carbon dioxide to 6 mmHg. One additional 5-mm trocar was placed cephalad to the 30-mm incision. When we performed this RAT, we detected no effect of the prior irradiation. To the best of our knowledge, this is the first report of RAT after irradiation. The cosmetic outcome of RAT is clearly superior, and the present case demonstrates that a RAT can be safely performed in carefully selected patients even after irradiation.

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Thyroid Disease Following Irradiation for Benign Conditions

Cited by 35 publications

References 3 publications

Parathyroid adenomas following irradiation

Parathyroid adenomas following irradiation

Head and neck neoplasia following irradiation for benign conditions

Remote-access hemithyroidectomy in a patient with papillary thyroid cancer after ipsilateral irradiation: a case report

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