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Introduction: Sarcomas in irradiated areas are rare diseases with an unfavorable prognosis. If complete tumor resection is the first-line treatment, the place of radiotherapy in a curative approach is not clearly defined. Methods: We report a rare case of Radiation-Induced Sarcoma (RIS) that arose in the thyroid, 27 years after radiotherapy for a localized undifferentiated nasopharyngeal carcinoma (UCNT). The patient was treated in 1992 with radiotherapy and chemotherapy intended to treat curatively. Twenty-seven years after the end of radiotherapy, the patient presented with a sarcoma in thyroid for which she received an initial surgical resection with positive margins followed by adjuvant radiotherapy. Results: The patient presented with a progression of her disease within one month of the end of radiotherapy. Conclusion: The complete surgical resection sarcoma within the irradiated field is often difficult to achieve enhancing the risk of relapse. Radiation therapy should be discussed when faced with an unrespectable tumour or after suboptimal surgery as part of intensified local management with curative intent. [ABSTRACT FROM AUTHOR]