Radiation induced primary hypothyroidism: Expect the unexpected?

Adults and children who were exposed to head and/or neck radiotherapy for different cancers associate a life time higher risk than general population for a heterogeneous panel of secondary conditions like thyroid nodules, cancer and radiation induced primary hypothyroidism. We introduce an adult female case who was diagnosed and treated for Hodgkin lymphoma type IIB and one year after she presented non-autoimmune thyroiditis and high TSH. Hypothyroidism was substituted for 29 years; the ultrasound pattern remained hypoechoic with a relatively small gland and also associated radiation induced lung fibrosis.