Oropharyngeal Cancer in a Thalassemic Patient: Role of Iron Overload in Carcinogenesis

Abstract

ABSTRACT The thalassemia syndromes are inherited α and β globin biosynthesis disorders. Patients with β thalassemia major require intensive blood transfusions to survive. Chronic blood transfusions can lead to blood-borne infections, alloimmunization, febrile reactions, and lethal iron overload. With the recent advances in treatment approaches and improvements in chelation therapy, thalassemic patients are living longer. Because of this, new complications are emerging, the majority of which are related to the treatment, and few are related to the primary pathology. One of the rarely reported complications is malignancy. The role of iron in carcinogenesis is still debatable. The role of iron in colorectal, liver, kidney, lung, and stomach cancer either as a cancer initiator or as a promoter is well documented. The most probable causes are iron autooxidation, pro-inflammatory cytokines activation of oxidative responsive transcription factors, and iron-induced hypoxia signaling. However, there is hardly any literature mentioning the role of iron in head-and-neck cancers. We report a case of oropharyngeal cancer in a thalassemia patient and discuss the possibility of association between the two diseases with emphasis on the aggressiveness of the cancer in the background of thalassemia and iron overload.