Post-radiotherapy Thyroid Cartilage Chondroradionecrosis

Radiotherapy is a widely used treatment modality for various cancers, particularly head and neck malignancies. While effective, it can result in a range of adverse effects and complications that impact the patient's quality of life. Chondroradionecrosis (CRN) has been identified as a significant concern, particularly affecting the laryngeal cartilage. We present the case of a 55-year-old male diagnosed with poorly differentiated cancer of the left thyroid lobe with areas of anaplastic differentiation. He underwent total thyroidectomy in April 2021, followed by external beam radiation therapy (70 Gray in 35 fractions), which was completed in August 2021. The patient presented to the emergency department in August 2024 with complaints of neck swelling, dysphagia, and hoarseness for the past month, which had worsened over the previous 10 days. Radiological studies revealed a destructive osseous process involving the right lamina of the thyroid cartilage, characterized by cortical fragmentation and intraosseous air bubbles, accompanied by edematous changes in both vocal cords, resulting in subsequent airway narrowing. CRN can lead to substantial morbidity, including cartilage fragmentation, collapse, and potential loss of function. In this case study, we aim to explore the clinical manifestations and imaging findings of CRN involving the thyroid cartilage in patients undergoing radiotherapy.