RESUMO
BACKGROUND: High-dose radioiodine therapy following total thyroidectomy is standard for patients suffering from differentiated thyroid carcinoma and contributes significantly to their favourable prognosis. Due to active iodine accumulation, high focal radiation doses are received by the salivary glands. PATIENTS/RESULT: Report on two patients, who received multiple high-dose radioiodine treatments because of a differentiated metastatic thyroid carcinoma. A few years later, they developed a mucoepidermoid carcinoma of the salivary glands. Due to the high cumulative radiation dose, radiation-induced secondary malignancies following radiation-induced sialadenitis appears likely, although no causal connection could be proven. CONCLUSION: Consistent protection of the salivary glands during radioiodine therapy as well as the follow-up of the many long-term survivors of differentiated thyroid carcinomas is desirable to further lower the salivary gland-related side effects and to detect secondary malignancies as early as possible.
Assuntos
Carcinoma Mucoepidermoide/diagnóstico , Neoplasias Induzidas por Radiação/diagnóstico , Segunda Neoplasia Primária/diagnóstico , Neoplasias Parotídeas/diagnóstico , Neoplasias da Glândula Submandibular/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Adulto , Carcinoma Mucoepidermoide/cirurgia , Seguimentos , Humanos , Masculino , Neoplasias Induzidas por Radiação/cirurgia , Segunda Neoplasia Primária/cirurgia , Glândula Parótida/efeitos da radiação , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Radiografia , Radioterapia de Alta Energia , Reoperação , Glândula Submandibular/efeitos da radiação , Glândula Submandibular/cirurgia , Neoplasias da Glândula Submandibular/cirurgiaRESUMO
Case report of a 42 year old female, who received 14th-20th year of life six radioiodine therapies with altogether 19.2 GBq131I because of a papillary thyroid carcinoma. 17 years after the last therapy, she developed a histologically proven chronic radiogenic sialadenitis of the left submandibular gland. Further four years later, the right submandibular gland has been extirpated because of a mucoepidermoid carcinoma with infiltration of a regionary lymphatic node. Review of the previous published secondary-malignancies of the salivary glands after high-dose radioiodine therapies.