open access

Vol 21, No 3 (2016)
Published online: 2016-05-01
Submitted: 2015-06-02
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Secondary malignancy following radiotherapy for thyroid eye disease

Christopher C. Gillis, Eun Hae Chang, Khalid Al-Kharazi, Tom Pickles
DOI: 10.1016/j.rpor.2016.01.001
·
Rep Pract Oncol Radiother 2016;21(3):156-161.

open access

Vol 21, No 3 (2016)
Published online: 2016-05-01
Submitted: 2015-06-02

Abstract

Aim

To describe the first case of a secondary meningioma in a patient after radiation treatment for thyroid eye disease (TED). Secondarily to identify any additional cases of secondary malignancy resulting from radiotherapy for thyroid eye disease from our institutional experience.

Background

Thyroid eye disease (TED) is a self-limiting auto-immune disorder causing expansion of orbital soft tissue from deposition of glycosaminoglycans and collagen, leading to significant cosmetic and functional morbidity. Established management options for TED include: glucocorticosteroids, orbital radiotherapy, and surgical orbital decompression. Two large series on radiotherapy for TED have been reported without any cases of secondary malignancy.

Materials and methods

The case of a patient with visual failure, found to have a sphenoid wing meningioma after previous TED radiotherapy is described. We then reviewed 575 patients with at least 3-year follow-up receiving radiotherapy for TED at British Columbia Cancer Agency to identify other possible secondary malignancies.

Results

The patient had postoperative improvement in her vision without any identified complications. Three additional cases of hematologic malignancy were identified. The calculated risk in our population of developing a radiation-induced meningioma after TED with at least 3 years of follow-up of is 0.17% (1/575); with hematopoetic malignancies the risk for secondary malignancy is 0.7% (4/575).

Conclusions

Our calculated risk for secondary malignancy (0.17%, 0.7%) is similar to the reported theoretical risk published in the literature (0.3–1.2%). There is real risk for the development of a secondary malignancy after radiotherapy treatment of TED and treatment options should include consideration for this potential.

Abstract

Aim

To describe the first case of a secondary meningioma in a patient after radiation treatment for thyroid eye disease (TED). Secondarily to identify any additional cases of secondary malignancy resulting from radiotherapy for thyroid eye disease from our institutional experience.

Background

Thyroid eye disease (TED) is a self-limiting auto-immune disorder causing expansion of orbital soft tissue from deposition of glycosaminoglycans and collagen, leading to significant cosmetic and functional morbidity. Established management options for TED include: glucocorticosteroids, orbital radiotherapy, and surgical orbital decompression. Two large series on radiotherapy for TED have been reported without any cases of secondary malignancy.

Materials and methods

The case of a patient with visual failure, found to have a sphenoid wing meningioma after previous TED radiotherapy is described. We then reviewed 575 patients with at least 3-year follow-up receiving radiotherapy for TED at British Columbia Cancer Agency to identify other possible secondary malignancies.

Results

The patient had postoperative improvement in her vision without any identified complications. Three additional cases of hematologic malignancy were identified. The calculated risk in our population of developing a radiation-induced meningioma after TED with at least 3 years of follow-up of is 0.17% (1/575); with hematopoetic malignancies the risk for secondary malignancy is 0.7% (4/575).

Conclusions

Our calculated risk for secondary malignancy (0.17%, 0.7%) is similar to the reported theoretical risk published in the literature (0.3–1.2%). There is real risk for the development of a secondary malignancy after radiotherapy treatment of TED and treatment options should include consideration for this potential.

Get Citation

Keywords

Secondary malignancy; Thyroid eye disease; Radiotherapy; Meningioma

About this article
Title

Secondary malignancy following radiotherapy for thyroid eye disease

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 21, No 3 (2016)

Pages

156-161

Published online

2016-05-01

DOI

10.1016/j.rpor.2016.01.001

Bibliographic record

Rep Pract Oncol Radiother 2016;21(3):156-161.

Keywords

Secondary malignancy
Thyroid eye disease
Radiotherapy
Meningioma

Authors

Christopher C. Gillis
Eun Hae Chang
Khalid Al-Kharazi
Tom Pickles

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