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Radiotherapy induced malignancy - Second Primary SCC cervical oesophagus presenting as tracheoesophageal fistulae following treatment for locally invasive thyroid cancer with post-operative adjuvant radiotherapy
EP29116
Poster Title: Radiotherapy induced malignancy - Second Primary SCC cervical oesophagus presenting as tracheoesophageal fistulae following treatment for locally invasive thyroid cancer with post-operative adjuvant radiotherapy
Submitted on 09 Sep 2018
Author(s): Dr.Amy Eccles, Dr. Michelle Akhunbay-Fudge, Dr. Fahim Ul-Hassan, Dr. Manil Subesinghe, Mr. Ricard Simo
Affiliations: Guy's and St. Thomas' NHS Foundation Trust
Poster Views: 267
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Poster Information
Abstract: Thyroid malignancy is often successfully managed with surgical excision with or without adjuvant radio iodine ablation with a 10 year survival rate of 80-90%. External beam radio therapy should be considered in patients with a “…high risk of recurrence / progression with: (a) gross evidence of local tumour invasion at surgery with significant macroscopic residual disease, or (b) residual or recurrent tumour that fails to concentrate radioiodine i.e. loco-regional disease where further surgery or radioiodine is ineffective or impractical”1.
It is important to be aware of the risk of inducing additional malignancies and careful consideration of risks and benefits of treatment is recommended. When patients present with signs of malignancy after a prolonged interval following treatment for thyroid malignancy, a second primary tumour should be within the differential and repeat tissue sampling is advocated2
Summary: In this case report, we present a 41 year old female patient who had previously undergone surgical de-bulking, radio iodine ablation and external beam radiotherapy for management of locally advanced thyroid cancer in 2006 and malignancy went on to develop a second of the cervical oesophagus over 10 years after her original cancer diagnosis felt to be a consequence of initial treatment.References: 1.Perros, P. , Boelaert, K. , Colley, S. , Evans, C. , Evans, R. M., Gerrard BA, G. , Gilbert, J. , Harrison, B. , Johnson, S. J., Giles, T. E., Moss, L. , Lewington, V. , Newbold, K. , Taylor, J. , Thakker, R. V., Watkinson, J. and Williams, G. R. (2014), Guidelines for the management of thyroid cancer. Clin Endocrinol, 81: 1-122
2.Braunstein, S., Nakamura, J.L. Radiotherapy-induced malignancies: Review of clinical features, pathobiology, and evolving approaches for mitigating risk. Front Oncol. 2013;3:73
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