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We evaluated the results of treatment of 215 pediatric patients with papillary thyroid carcinoma (PTC). Median age at diagnosis was 14 (5 - 18 y.o). Thyroidectomy performed in 105, subtotalthyroidectomy in 8, lobectomy - in 102, additional lymph node dissection - in 169, radioiodine ablation/ therapy - in 102 patients. Follicular variant PTC was found in 41 (19%), solid - in 37 (17%), diffuse sclerosing - in 3 (1%), the remaining had a classical PTC with mainly papillary (90; 42%) or follicular (44; 21%) pattern. 21% had multifocal PTC, 4,6% - extrathyroidal extension, 62% - regional lymph node metastases, 12% - lung metastases. The follow up was 95 months (6 - 301 mo). All patients are alive. Recurrence of PTC occurred in 37 (17%): 7 - thyroid remnant, 26 - cervical lymph nodes, 4 - distant lung metastases. Prognostic factors for distant metastases were young age at diagnosis <12 years old (OR 3.4, р <0.022), tumor size more then 3 cm (OR 3.2, р <0.027) and lateral cervical lymph node metastases (OR 21.39, р <0.0001). Risk of recurrence was higher in multifocal PTC (OR 2.4, р <0.009), regional lymph node metastases (OR 7.4, р <0,008) and distant metastases (OR 3.2, р <0,01). The highest risk of relapse had the patients with solid variant of PTC. Radical surgery diminished the risk of relapse (OR 0.3, р <0.002). There was no evidence of impact of radioiodine therapy on risk of recurrence (р=0.66).

Struma ovarii is a rare variant of the mature ovarian teratoma composed of more than 50% thyroid tissue. Thyroid type carcinoma can occur in 5% of struma ovarii. Given the rarity of this pathology, as well as the different clinical course, approaches to the treatment of this disease are controversial. The proposed approaches to treatment vary from ovarian resection to total hysterectomy with bilateral salpingo-oophorectomy and adjuvant therapy. We present here 6 case reports of thyroid type carcinoma in struma ovarii and outcome of patients treated in our clinic. All patients had pelvic surgery of different extent, followed by thyroidectomy and radioiodine therapy. The incidence of metastasis is 67% (4/6), 2 - intraperitoneal metas-tases, 2 - bone metastases. Among patients with metastases, 2 have reached a complete response, one with a good response continues treatment, one had progression. The follow-up period is 1 to 15 years (median 4 years). One patient with follicular carcinoma died of progression 8 years after diagnosis. The remaining patients are alive.

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