Clinical and Pathological Features of Pediatric Thyroid Carcinoma

A. Brehar; A. Bulgar; C. Procopiuc; C. Dumitrescu; D. Paun; I. Gherlan; D. Ioachim; M. Ghemigian; B. Stanescu; M. Ionescu; D. Brasoveanu; A. Goldstein; M. Belgun; C. Dumitrache

Introduction: Thyroid cancer in childhood and adolescence represents 1.5–3% of all carcinomas in this group of age. Our purpose is to define clinical and pathological features, therapeutical complications and follow-up characteristics and survival of a group of children and adolescents with thyroid carcinomas.

Design: We report a retrospective study of 26 children and adolescents with thyroid carcinoma who were investigated in our institution from January 2007 till July 2011. The study followed: historical data, clinical examination, hormonal profile, imaging, histological examination, side effects of therapeutic interventions, the locoregional/distant recurrence.

Results: There were 23 girls and 3 boys in our group. The average age at diagnosis was 14.9 years (15.1 years for girls and 13.33 years for boys). At the time of diagnosis 8 patients presented with unique nodule, 13 patients with nodule with laterocevical lymphadenopathy and 5 patients had multinodular goiter. The treatment applied was total thyroidectomy followed by radioiodine therapy. There was one case of persistent hipoparathyroidism and no other significant post-operative/radioiodine therapy were observed and no patients died from disease. Histological examination revealed papillary differentiated thyroid carcinoma: diffuse sclerosing papillary thyroid carcinoma and follicular variant were the subtypes observed. 30% of patients presented a tumor size between 3 cm and 4 cm. The involvement of thyroid capsule and surrounding tissue was observed in 40% of cases and multicentricity was described in 20% of cases. Postoperative surveillance was done by clinical examination, imaging and repeated dosing of thyroglobulin and antitireoglobuline antibodies. 4 patients exhibited local recurrence.

Conclusions: Compare with adult DTC, the pediatric DTC has an aggressive behavior at presentation, a higher risk of recurrences and a risk of induction of a secondary solid tumor after iodine therapy in later life, which require an improved protocol of treatment and follow-up.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector

Endocrine Abstracts

P1833