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Radiation and thyroid disease.

L J DeGroot

    Bailliere'S Clinical Endocrinology and Metabolism
    |August 1, 1988
    PubMed
    Summary
    This summary is machine-generated.

    External thyroid irradiation increases thyroid cancer risk, with most cases linked to past treatments for conditions like enlarged glands. Surgery is recommended for suspected cancers due to high multicentricity.

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    Area of Science:

    • Endocrinology
    • Oncology
    • Radiology

    Background:

    • External thyroid irradiation is a known risk factor for thyroid malignancies.
    • The incidence rate is approximately 5 cases per rad per million people annually.
    • Previous treatments for conditions like thymic enlargement, tonsil/adenoid issues, and acne are common historical exposures.

    Purpose of the Study:

    • To review the incidence, characteristics, and management of radiation-associated thyroid disease.
    • To discuss diagnostic and surgical approaches for these malignancies.
    • To evaluate the impact of external irradiation versus radioactive iodine on thyroid health.

    Main Methods:

    • Review of clinical data and literature on external irradiation and thyroid abnormalities.
    • Analysis of tumour types, clinical course, and treatment outcomes.

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  • Comparison of risks associated with external X-ray versus 131I treatments.

    • Main Results:

    • External irradiation can lead to differentiated thyroid malignancies, adenomas, hypothyroidism, and potentially autoimmune thyroid disease.
    • Multinodularity in irradiated patients suggests a higher likelihood of malignancy and warrants surgical investigation.
    • Near-total thyroidectomy is preferred due to the high incidence of multicentricity.
    • Radioactive iodine (131I) treatments have not shown a clear association with increased thyroid malignancy.

    Conclusions:

    • External thyroid irradiation significantly elevates the risk of developing thyroid cancer and other abnormalities.
    • Careful diagnosis and surgical intervention, often near-total thyroidectomy, are crucial for managing radiation-associated thyroid cancer.
    • While external irradiation poses risks, 131I appears to have a different risk profile regarding malignancy.