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Gillis CC, Chang EH, Al-Kharazi K, et al. Secondary malignancy following radiotherapy for thyroid eye disease. Rep Pract Oncol Radiother. 2016;21(3):156-61doi: 10.1016/j.rpor.2016.01.001.
Gillis, C. C., Chang, E. H., Al-Kharazi, K., & Pickles, T. (2016). Secondary malignancy following radiotherapy for thyroid eye disease. Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology, 21(3), 156-61. https://doi.org/10.1016/j.rpor.2016.01.001
Gillis, Christopher C, et al. "Secondary malignancy following radiotherapy for thyroid eye disease." Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology vol. 21,3 (2016): 156-61. doi: https://doi.org/10.1016/j.rpor.2016.01.001
Gillis CC, Chang EH, Al-Kharazi K, Pickles T. Secondary malignancy following radiotherapy for thyroid eye disease. Rep Pract Oncol Radiother. 2016 May-Jun;21(3):156-61. doi: 10.1016/j.rpor.2016.01.001. Epub 2016 Feb 08. PMID: 27601944; PMCID: PMC5002015.
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Rep Pract Oncol Radiother. 2016 May-Jun;21(3):156-61. doi: 10.1016/j.rpor.2016.01.001. Epub 2016 Feb 08.

Secondary malignancy following radiotherapy for thyroid eye disease.

Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology

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

Affiliations

  1. Division of Neurosurgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, United States; Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
  2. Department of Otolaryngology, University of Nebraska Medical Center, Omaha, NE, United States; Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
  3. Weil Cornell Medical College at Qatar, Al Rayyan, Qatar; Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
  4. Division of Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Vancouver, BC, Canada; Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada; Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.

PMID: 27601944 PMCID: PMC5002015 DOI: 10.1016/j.rpor.2016.01.001

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.

Keywords: Meningioma; Radiotherapy; Secondary malignancy; Thyroid eye disease

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