Christopher C Gillis1, Eun Hae Chang2, Khalid Al-Kharazi3, Tom Pickles4. 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.
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.
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.
Authors: A Snijders-Keilholz; R J De Keizer; B M Goslings; E W Van Dam; J T Jansen; J J Broerse Journal: Radiother Oncol Date: 1996-01 Impact factor: 6.280
Authors: Alicia Marín; Margarita Martín; Olga Liñán; Felipe Alvarenga; Mario López; Laura Fernández; David Büchser; Laura Cerezo Journal: Rep Pract Oncol Radiother Date: 2014-08-28