Papillary Carcinoma of the Thyroid: Hereditary or Radiation-Induced?

Abstract

Familial medullary thyroid carcinoma (MTC) is a well-known syndrome, however, familial papillary thyroid carcinoma has been documented infrequently in brief reports and family members diagnosed with this disease usually involve a small number of patients. In this issue of the journal, Dr. Harris and colleagues report two members of a family with papillary thyroid carcinoma: a mother and her young daughter who presented with metastatic papillary thyroid carcinoma. The authors suggest that the occurrence of the neoplasm at an advanced stage in closely related individuals early in life may be due to an underlying genetic abnormality. The mother, 17 years earlier at the age of 22, received brief treatment with localized posterior scalp irradiation for tinea capitis with her face and neck heavily shielded? However, I am not certain how the shielding was done, especially since thyroid carcinoma may arise in a thyroid which received a small amount of radiation. We have previously reported that lead shielding of some organs such as the thyroid during treatment of nasopharyngeal carcinoma is far from adequate protection (1,2). The same is true for the testicles (3). So, some irradiation to the mother's thyroid cannot be excluded. However, we should not detract from the fact that there is a familial form of papillary carcinoma of the thyroid (PCT).