Surreal illustration of thyroid gland with radiation symbols, symbolizing the link between radiation exposure and thyroid health.

Thyroid Cancer and Radiation Exposure: What You Need to Know

Reese Marlowe in Health & Wellness August 2025 • 4 min read.

"A Case Study Reveals the Link Between Occupational Radiation and a Rare Thyroid Cancer"

Thyroid cancer is a relatively rare malignancy, but its incidence has been increasing in recent years. While several factors can contribute to its development, including genetics and iodine deficiency, exposure to radiation is a well-established risk factor. A recent case study highlights the potential link between occupational radiation exposure and a rare and aggressive form of thyroid cancer known as epithelioid angiosarcoma (EAS).

Angiosarcoma of the thyroid is an extremely rare tumor, accounting for less than 1% of all thyroid malignancies. It is characterized by its aggressive behavior and poor prognosis. While the exact cause of thyroid angiosarcoma is unknown, it has been associated with iodine deficiency and, notably, radiation exposure.

This article delves into a fascinating case study that explores this connection, offering insights into risk factors, diagnosis, treatment, and potential preventative measures.

Unveiling the Case: Radiation Exposure and Thyroid Cancer

Surreal illustration of thyroid gland with radiation symbols, symbolizing the link between radiation exposure and thyroid health.

Researchers reported the case of a 63-year-old interventional cardiologist who developed primary epithelioid angiosarcoma of the thyroid. What made this case particularly interesting was the patient's 15-year history of working in an angiographic room, exposing him to occupational radiation. The patient, who lived in a non-iodine-deficient area and had no prior history of thyroid disease, presented with rapid onset of dyspnea and dysphonia.

Initial investigations revealed a large neck mass originating from the left thyroid lobe, causing displacement and stenosis of the trachea. A fine-needle aspiration led to a diagnosis of malignancy, and the patient underwent a total thyroidectomy and lymphadenectomy. The final pathological diagnosis confirmed high-grade epithelioid angiosarcoma (EAS).

Diagnosis and Staging: The patient's diagnosis involved a combination of imaging techniques (CT scans) and pathological examination of tissue samples obtained through fine-needle aspiration and surgery. Staging revealed that the tumor was confined to the thyroid, with no evidence of lymph node metastases.
Treatment: Following surgery, the patient received chemotherapy with Epirubicin and Ifosfamide. However, treatment was discontinued after four cycles due to significant bone marrow toxicity.
Follow-up: Remarkably, the patient remained alive and free of disease 62 months after the initial diagnosis. Follow-up CT scans of the neck, chest, abdomen, and pelvis revealed no signs of metastases.

This case underscores the potential risk of occupational radiation exposure and the importance of preventative measures. While the association between radiation therapy and angiosarcoma is well-documented, this case highlights the need for awareness in occupational settings where radiation exposure may be less obvious.

The Takeaway: Awareness and Prevention

While this case study provides valuable insights into the link between occupational radiation exposure and thyroid angiosarcoma, further research is needed to fully understand the underlying mechanisms and identify effective preventative strategies. Raising awareness among healthcare professionals and individuals working in potentially hazardous environments is crucial for early detection and prevention.

About this Article -

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This article is based on research published under:

DOI-LINK: 10.3389/fendo.2018.00577, Alternate LINK

Title: Primary Epithelioid Angiosarcoma Of The Thyroid In A Patient Occupationally Exposed To Radiations

Subject: Endocrinology, Diabetes and Metabolism

Journal: Frontiers in Endocrinology

Publisher: Frontiers Media SA

Authors: Michela Marina, Luigi Corcione, Maria Francesca Serra, Teore Ferri, Enrico Maria Silini, Graziano Ceresini

Published: 2018-10-01

Everything You Need To Know

What exactly is epithelioid angiosarcoma (EAS) of the thyroid, and why is it considered such a serious condition?

Epithelioid angiosarcoma (EAS) is an extremely rare and aggressive form of thyroid cancer, representing less than 1% of all thyroid malignancies. Its aggressive nature often leads to a poor prognosis. While the exact cause isn't fully understood, it's been linked to iodine deficiency and, significantly, exposure to radiation. It's crucial to understand that angiosarcoma, in general, is a cancer that begins in the lining of blood vessels and lymphatic vessels, making its presence in the thyroid a unique and concerning event. Further research is necessary to fully elucidate the underlying mechanisms contributing to its development.

Can you elaborate on the specifics of the case study mentioned, particularly the patient's background and symptoms?

The case study featured a 63-year-old interventional cardiologist with a 15-year history of occupational radiation exposure in an angiographic room. He developed primary epithelioid angiosarcoma of the thyroid. His symptoms included rapid onset of dyspnea (difficulty breathing) and dysphonia (hoarseness). What makes this case particularly interesting is the absence of other common risk factors such as iodine deficiency or prior thyroid disease, pointing to occupational radiation as a likely contributing factor. This highlights the importance of considering occupational hazards in the development of such rare malignancies.

What were the diagnosis and treatment strategies employed in the case, and what was the outcome for the patient?

The patient underwent a combination of imaging techniques such as CT scans, fine-needle aspiration, total thyroidectomy, and lymphadenectomy. After surgery, the patient received chemotherapy with Epirubicin and Ifosfamide. Despite bone marrow toxicity leading to discontinuation after four cycles, the patient remarkably remained alive and disease-free 62 months after diagnosis. This underscores the significance of early detection and aggressive treatment approaches in managing this rare and aggressive cancer. The success in this case, while notable, doesn't negate the general poor prognosis associated with epithelioid angiosarcoma.

What preventative measures can be taken to minimize the risk of developing thyroid angiosarcoma, especially in occupational settings with potential radiation exposure?

The case underscores the potential dangers of occupational radiation exposure, especially in settings where it might not be immediately obvious. Preventative measures should include strict adherence to radiation safety protocols, regular monitoring of radiation exposure levels, and the use of protective equipment. Healthcare professionals and individuals working in such environments should be aware of the risks. This awareness is critical for early detection, which can significantly impact treatment outcomes. It is worth noting that while this case study highlights the risk, the overall incidence of epithelioid angiosarcoma remains low.

What further research is needed to better understand the link between radiation exposure and thyroid angiosarcoma, and what are the implications for future prevention and treatment strategies?

While the case study provides valuable insight into the connection between occupational radiation exposure and epithelioid angiosarcoma, further research is needed to fully understand the underlying mechanisms and identify more effective preventative strategies. Raising awareness among healthcare professionals and at-risk individuals is crucial for early detection and prevention. Future research should focus on genetic predispositions, synergistic effects of radiation with other risk factors, and the development of targeted therapies that can improve the prognosis for patients diagnosed with this rare and aggressive cancer. This is particularly important, as the long-term effects of even low-dose radiation exposure are still not fully understood.