Non-Alpine Thyroid Angiosarcoma After Radiation Exposure: A Case Report

Objective: We review the literature of thyroid angiosarcoma and present the first reported case of a man diagnosed with non-Alpine thyroid angiosarcoma after longstanding exposure to neck radiation, delineating its treatment and favorable outcome. Methods: An elderly man from Iraq with previous longstanding radiation exposure to the neck had undergone surgical resection for an incidental neck mass. Histologic analysis indicated thyroid angiosarcoma. One year after adjuvant radiation therapy, he remains free of signs and symptoms of recurrence. We conducted an online search of the literature, collecting data from case series and literature reviews, the highest levels of evidence currently available, to describe the epidemiology, symptoms, histology, and treatment of thyroid angiosarcoma. Results: Thyroid angiosarcoma is a rare disease, occurring most often in Alpine regions where iodine deficiency is prevalent. Its etiology has yet to be firmly established. Evidence, primarily from histologic markers, is growing that it is distinct from anaplastic thyroid cancer. Nevertheless, it has a poor prognosis even after treatment with radiation and chemotherapy, of which there is no formal protocol. Conclusion: Although the full spectrum of risk factors for non-Alpine thyroid angiosarcoma remains unclear, this case suggests that radiation exposure is a potential causative agent and such cases may have a better outcome after treatment. Abbreviations: CD cluster of differentiation CT computed tomography