Epidemiological evidence for a common mechanism for neuroblastoma and differentiated thyroid tumour

Abstract

Summan-Because genetic predisposition probably plays an important role in the aetiology of most of childhood cancers. studies of second primaries occurring after these cancers may be particularly informative about possible common genetic mechanisms in both of these cancers. We have studied the incidence of thyroid tumours occumng after cancer in childhood in a cohort of 592 children treated before 1970. Among these children. six later developed a thyroid carcinoma, and 18 developed a thyroid adenoma. Radiation doses received to the thyToid by each of the irradiated children have been estimated using individual radiotherapeutic technical records. Thyroid carcinomas and thyroid adenomas were five times more frequent after irradiation for neuroblastoma than after irradiation for anv other first cancer. This ratio did not depend on sex. nor on time elapsed since irradiation. nor on dose of radiation received for the thyToid gland. This result suggests that there is a common mechanism for the occurrence of neuroblastoma and of differentiated thyroid tumour.

Non-Hodgkin lymphoma (NHL) as a second neoplasm occurring after neuroblastoma treatment

“…Second malignancies after neuroblastoma described up to now were malignant tumors of the parotid [14], kidney cell carcinoma [15], osteogenic sarcoma [16], carcinoma and adenoma of the thyroid gland [17], acute lymphoblastic leukemia [8], and myelodysplastic syndrome and its transition to acute myelogenous leukemia [18].…”

Thyroid Sequelae of Pediatric Cancer Therapy

“…In a follow-up study by the same group of investigators, non-palpable thyroid nodules (most being benign nodules <1 cm in size) were found in 9/16 (56%) survivors, including 2 cases of PTC [54]. Although there may be elevated thyroid cancer risk in neuroblastoma due to cancer therapy, common genetic factors and mechanisms of tumorigenesis between these 2 malignancies may also play a role [98, 99]. …”

Improved radiation protection of the thyroid gland with thyroxine, methimazole, and potassium iodide during diagnostic and therapeutic use of radiolabeled metaiodobenzylguanidine in children with neuroblastoma

“…13,14 Furthermore, thyroid tissue in children appears to be more radiosensitive than in adults, [15][16][17] and children with neuroblastoma may even be more susceptible to radiation effects on this gland compared with children who have other malignancies. 18 To protect the thyroid against these adverse radiation effects, it is common practice to administer excessive amounts of potassium iodide during exposure to radioiodide. For instance, in nuclear accidents, such a radiation protection is advised for both adults and children.…”