Endocrine Abstracts

Introduction: Advancement in modalities of treatment in childhood malignancies has improved the survival. Though Hypothyroidism is the first recognised and commonest thyroid disease in these set of patients, there is also an increased risk of subsequent primary thyroid cancer among the Survivors childhood malignancies who have had radiotherapy to the head, neck, or upper thorax. We hereby present case series of five patients who developed thyroid cancer after childhood cancer therapy.

The average age group of the patients is 27.4 (24–39). Three of these had ALL, two other patients had Hodgkin’s disease and AML each. Average age at diagnosis of primary malignancy was 11 (1–25 years) and average duration between treatment of primary malignancy and diagnosis of thyroid cancer was 13.2 (7–21 years). Of the three patients with ALL, one had cranial irradiation with initial chemotherapy and two others had Total body radiation. Patient with AML had total body radiation before allogeneic bone marrow transplant and one with Hodgkin’s disease had chemotherapy only. Three of these patients presented with thyroid lump and two others were diagnosed on ultrasound scan. All five patients had papillary thyroid cancer. Only one of these had local metastasis to lymph nodes. All patients had total thyroidectomy with level six neck dissection followed by Radio iodine ablation.

Conclusion: Papillary thyroid cancer is commonest type of thyroid cancer in survivors from childhood cancer therapy. Radiation increases the risk for development of thyroid cancer. Standard long-term follow-up of patients treated for childhood malignancies particularly requiring radiation to head and neck region should include thyroid ultrasound for early detection of the cancer.