Thyroid neoplasm after central nervous system irradiation for medulloblastoma in childhood: report of two cases.
OBJECTIVE
Surgical excision combined with radio-chemotherapy represents the gold standard of therapy of medulloblastoma. The effectiveness of such a combined treatment has encouraged the use of radiotherapy even in young paediatric patients, in spite of the many adverse effects reported in literature, and, in particular, the increased risk of a second radioinduced malignancy. Irradiation is the well-known risk factor for development of benign and malignant thyroid tumours. Children are more exposed to this risk because of their thyroid gland is more sensitive to carcinogenic effect of ionising radiation.


METHODS
Two children underwent radiotherapy for the treatment of a medulloblastoma when they were 3 and 4 years old, respectively. At the age of 20 and 23, both of them underwent the surgical excision of a papillary thyroid carcinoma, 20 and 17 years after the radiotherapeutic treatment, respectively.


CONCLUSIONS
Radioinduced thyroid tumours are a well-recognised nosographic entities due to the particular sensitivity of this gland to ionising radiations. However, only a few papers on radioinduced thyroid neoplasms after CNS irradiation have been published in the literature. We report on two additional cases of thyroid neoplasms following childhood CNS irradiation for the treatment of a posterior fossa medulloblastoma.
Pettorini
Benedetta Ludovica
BL
Paediatric Neurosurgery Unit, Catholic University, Largo Agostino Gemelli, 800168 Rome, Italy. benedettaludovica@virgilio.it
Narducci
Alessandro
A
de Carlo
Antonella
A
Abet
Francesca
F
Caldarelli
Massimo
M
Massimi
Luca
L
Tamburrini
Gianpiero
G
Di Rocco
Concezio
C
D002291:Carcinoma, Papillary / Q000209:etiology*; D002528:Cerebellar Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008527:Medulloblastoma / Q000473:pathology / Q000532:radiotherapy*; D009381:Neoplasms, Radiation-Induced / Q000209:etiology*; D013964:Thyroid Neoplasms / Q000209:etiology*; D055815:Young Adult