Introduction 
Advanced techniques of radiotherapy have decreased the late 
complication rate to < 1% at the larynx. Cartilage necrosis is 
one of rare toxicities associated with radiotherapy. 
Case presentation 
 
We present the case of post-irradiation thyroid cartilage 
necrosis in an adult patient with glottic cancer. The 
radiotherapy was performed 3 weeks after primary surgery 
using CO2 laser (hemi-laryngectomy, neck dissection). The 
cancer region and bilateral lymph nodes were exposed to a 
daily fraction of 1.8 Gy up to a total dose of 59.4 Gy in 
IMRT technique. 5.5 months after radiotherapy the patient 
suffered from serious dyspnoea and dysphonia. Laryngeal 
edema and an unknown mass in the anterior larynx 
commissure were seen during the ENT examination. During 
the direct endoscopy a “foreign body” was removed and 
edematous tissue was visualized in the surrounding region. 
Histological examination showed necrotical cartilage 
without evidence of cancer recurrence. After postoperative 
anti-edematous, mycolytic and antibiotic therapy the patient 
was discharged free of complaints.