Endocrine Abstracts

Introduction: Thyroid cancer (TC) is a rare disease in childhood, with an incidence of 0.2 to 5 cases per million per year or higher [Neiva F., 2012, Tuli G, 2023]. The incidence of malignancy among thyroid nodules in children is about 16%, which is about three times higher than in adults [Vaisman F., 2011, Yeker R.M., 2022]. Lymph node metastases (40–80%) and distant metastases (25%) are also much more common in the pediatric population [Zirilli G., 2018, Thomas JK., 2021]. One of the important factors for the high risk of TC is iodine deficiency, which persists in Uzbekistan, although thanks to ongoing prevention, its prevalence has decreased by more than 2.5 times over the past 20 years [Ismailov S.I., 2018].

Objective: To assess the incidence of TC in children and adolescents based on admission to a tertiary hospital in the Republic of Uzbekistan.

Materials and methods: A retrospective study of 13, 509 medical histories and outpatient records of children and adolescents who received outpatient and inpatient treatment at the clinic of the RSSPMCE named after Academician Y.Kh. Turakulov for the period from 2016 to 2022 was conducted.

Results: During this period, 27 children with TC were identified, of which 24 were girls (89%) and 3 boys (11%), the gender distribution was 8.1:1. The average age was 17.5±2.7 years. TC was most common among school-age patients (44.4%), in second place - among university students (26%), then among lyceum students (14.8%), college (11.1%), and among working people (3.7%). In all children, palpation revealed grade 2 goiter, with 66.7% (18) of children diagnosed with nodular goiter, and 33.3% (9) with multinodular goiter. Total thyroidectomy was performed in 75% (18) of cases, subtotal - 16.7% (4), and 2 patients underwent hemithyroidectomy (8.3%). Histological examination of native thyroid tissue in all children we studied revealed differentiated TC; papillary TC was diagnosed 2 times more often than follicular carcinoma. There were no cases of medullary and anaplastic TC. Radioiodine ablation with I131 was performed in only 20.8% of children.

Conclusion: TC remains a pressing and little-studied problem. Most often, children are diagnosed with papillary TC with a solid euthyroid node in adolescence, while in girls it is detected 8 times more often. The average TI-RADS values in children with TC according to ultrasound data are 4.2±0.2, histological examination data are 4.14±0.34 according to Bethesda. Further population-based prospective studies of TC in the pediatric population are necessary.