Effective management of a patient with secondary male breast cancer after neck radiotherapy for tonsillar lymphoma

Recent advances in surgical techniques, chemotherapy and radiotherapy led to significant increase in the number of long-term cancer survivors, but on other hand with increased probability of adverse effects, including the development of a secondary malignant neoplasm. this is especially important to consider when there is the need to provide treatment recommendations for patients undergoing radiotherapy keeping in mind the potential risks of toxicity associated with possession of specific genetic variants. we reported the clinical case of a patient in whom rare malignancies associated to genetic mutation have been treated and managed in the best way thanks to the support of radiotherapist. in particular a male patient with positive family history of brca2 mutation, developed breast cancer after radiotherapy for a rare tonsillar non-hodgkin lymphoma. we highlight that the knowledge of all aspects of the diseases, of all treatments secondary effects, in particular of ionizing radiation in patients with potential genetic risk of toxicity, allowed an optimal management of the case.