Continuing Occurrence of Thyroid Carcinoma after Irradiation to the Neck in Infancy and Childhood

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Abstract
To determine wether the occurrence of x-ray-induced thyroid carcinoma has not declined, we examined 100 patients with a history of irradiation to the neck area. Irradiation had been given to tonsils (42 per cent), adenoids (10 per cent), tonsils and adenoids (7 per cent) and thymus (30 per cent), for acne (7 per cent), and for various other reasons (7 per cent). Operation was recommended to 18 of 26 patients with palpable abnormalities and 15 were operated upon; we found seven carcinomas, and eight benign lesions. Five of six carcinomas had invasive characteristics, with or without metastases, five of seven were multifocal, and six of seven had a follicular component. Of seven patients irradiated to both tonsils and adenoids and thus receiving higher radiation exposure, two had carcinoma, suggesting a dose relation. The overall 7 per cent prevalence of carcinoma in unselected patients with a history of irradiation to the neck area is higher than expected and implies a continuing important public-health problem, at least in the Chicago area. (N Engl J Med 292:171–175, 1975)

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