Endocrine Abstracts

Introduction: Thyroid cancer is rare in the pediatric population, but thyroid carcinomas occurring in children carry a unique set of clinical, pathologic, and molecular characteristics. In comparison to adults, children more often present with aggressive, advanced stage disease. The aim of the study is to determinate the clinical, histological and therapeutic aspects of differentiated thyroid cancer in children and adolescents.

Materials and Methods: This is a retrospective study about 6 cases of pediatric thyroid cancer collected in ENT department of Fattouma Bourguiba Hospital of Monastir during a 20-year period (2000-2020).

Results: The average age was 15 years, gender-ratio was 0,2. No personal history of radiation exposure and family history of thyroid cancer were noted. All of patients presented to our consultation for management of a thyroid nodule, associated, in one case, with middle jugular node measuring 2 cm in diameter. All of patients underwent a total thyroidectomy, associated to bilateral central neck lymph node dissection in 3 cases and ipsilateral central neck lymph node dissection in 2 cases. A lateral lymph node dissection was performed in 2 cases. Histologic examination confirmed the diagnosis of papillary carcinoma in all cases. The mean tumor size was 3 cm. In all cases, papillary thyroid carcinoma was multifocal. We noted a tumor capsular invasion in 2 cases. Lymph node metastasis were along the recurrent nerve chain in all cases and in jugular chain in 2 cases. Surgical treatment was followed by radioactive iodine therapy in all cases. There was no distant metastasis or cancer recurrence after a mean follow-up of 3 years,

Conclusion: Although children with differentiated thyroid cancer typically present with locoregional metastases and a high rate of distant metastatic disease, overall survival is very good. Treatment should be based on their increased risk for recurrence instead of overall mortality, and lifelong follow up is required because recurrence and death may not occur for decades after diagnosis.