Cancer of the thyroid in youth

Buckwalter, Joseph A.; Gurll, Nelson J.; Thomas, Colin G.

doi:10.1007/bf01657826

Cited by 82 publications

(37 citation statements)

References 23 publications

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“…Since 1970, several additional studies on thyroid neoplasms in children after external X-ray therapy have been published (Table 2). 31,[43][44][45][46][47][48][49][50] Other studies of thyroid carcinoma after different sources of radiation exposure have shown an increase in incidence predominantly in the adult population. Thus, among the hundreds of cases of thyroid carcinoma in atomic bomb survivors of Hiroshima and Nagasaki, we could only find a description of two tumors in ~hi1dren.l~ Seven thyroid neoplasms were documented in residents from the Marshall Islands who were exposed to radioiodines in fallout from the 1954 atmospheric nuclear tests.…”

Section: Discussionmentioning

confidence: 99%

Pediatric thyroid cancer after the chernobyl disaster. Pathomorphologic study of 84 cases (1991–1992) from the republic of Belarus

Nikiforov

Gnepp

1994

Cancer

249

119

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Background. During the initial period after the Chernobyl accident, large amounts of radioactive iodine were released in fallout, resulting in serious exposure to the thyroid gland in the residents of areas around the nuclear power station. Beginning in 1990, a definite increase in the incidence of thyroid cancer was noted in children of the Republic of Belarus. Methods. Morphologic and clinical features of 84 cases of post‐Chernobyl thyroid carcinoma in Belarussian children from 5 to 14 years of age are reported. The latent period for tumor development was 4–6 years, with a mean of 5.8 years. Results. Papillary carcinoma was found in 83 patients and medullary carcinoma in one. Besides typical papillary carcinoma (14%), solid (34%), follicular (33%), mixed (10%), and diffuse sclerosing (9%) variants were observed. The follow‐up period ranged from 8 months to 2.5 years. One patient died, local recurrence developed in 2, and cervical lymph node metastases developed in 10. To date, the incidence of local recurrence or metastatic disease after surgery was significantly higher in patients 5–8 years of age and in residents of areas nearest to the Chernobyl station. Conclusions. Post‐Chernobyl pediatric thyroid carcinoma is characterized by a short latency, a higher proportion of tumors arising in young children, and an almost equal sex ratio. Microscopically, these tumors were usually aggressive, often demonstrating intraglandular tumor dissemination (92%), thyroid capsular and adjacent soft tissue invasion (89%), and cervical lymph node metastases (88%). Papillary carcinoma was diagnosed in 99% of cases, with an unusually high frequency of solid growth patterns. Morphologic changes in nonneoplastic thyroid tissue were present in 90% of the glands, and the most specific findings were vascular changes and perifollicular fibrosis. Cancer 1994; 74: 748‐66.

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Section: Discussionmentioning

confidence: 99%

Pediatric thyroid cancer after the chernobyl disaster. Pathomorphologic study of 84 cases (1991–1992) from the republic of Belarus

Nikiforov

Gnepp

1994

Cancer

249

119

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“…Because of its rarity there have been few detailed studies of the change in incidence with age and sex in childhood, or any change in incidence with time. Studies of large series of thyroid cancer in young children have been largely confined to major tertiary referral centres and have usually concentrated on the clinical behaviour and treatment rather than pathology Rosvoll, 1961, 1970;Buckwalter et al. 1981;Schlumberger et al, 1987;Zimmerman et al, 1988;Harness et al, 1992;Samuel and Sharma, 1991).…”

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confidence: 99%

Childhood thyroid cancer in England and Wales

Harach

Williams²

1995

Br J Cancer

160

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Summary A total of 154 cases of thyroid cancer in children under 15 were registered in England and Wales over a period of 30 years. an incidence of about 0.5 per million per year. A total of 4.5 cases per year were registered in 1963-72. 4.9 in 1973-82 and 5.8 in 1983-92. A rapid rnse in incidence with age occurred after the age of 5. Malignancy was confirmed in 92% of the cases in which tissue was available. Of these. 68% were papillary carcinomas. 110% follicular carcinomas and 17% medullarv carcinomas. There were two spindle cell tumours with mucous cysts and one teratoma. The increased frequency but small size of medullary carcinomas in the second half of the period suggested that this increase was due to the introduction of screening; it accounted for most of the rise in crude incidence rates with time. The sex ratio (F:M) in all registered cases in the differentiated follicular cell carcinoma groups in children aged under 10 was 1.2:1. and 3.6:1 in the older children. Five children with differentiated thyroid cancer of follicular cell origin died up to 17 years after diagnosis. Two of the eight children aged 9 or less with a 20 year follow-up died. compared with three of 28 older children. An unusual group of differentiated carcinomas showed solid or follicular architecture. These tumours were unencapsulated. often widely invasive, contained psammoma bodies but little or no papillary architecture and the nuclei often lacked prominent grooving. This childhood type of papillary carcinoma contrasted with the classical type commonly found in the adult, which was present in none of 13 confirmed papillary carcinomas in children aged less than 10. compared with 20 of 35 older children. These observations show that thyroid carcinoma in very young children has a different spectrum of histological types from both older children and adults. From the age of about 10 well-differentiated papillary carcinomas rapidly increase in frequency in females. so that the other types come to form only a small proportion of the total. These differences. and the lower incidence but poorer prognosis of thyroid carcinoma in men and the poorer prognosis in post-as compared with premenopausal women. are compatible with a major role for sex hormones in thyroid carcinogenesis in females during the reproductive period. This study documents the incidence of childhood thyroid cancer in England and Wales. explains the rise in crude incidence rates. shows differences between carcinomas in children under and over the age of ten which may correlate with puberty. and draws attention to an unusual aggressive type of childhood papillary carcinoma. It illustrates the value to crude registry data of a pathology revies.

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“…Eine radikale prophylaktische Neck dissection wird im Kindesalter abgelehnt [6]. Wegen der Neigung zum multifokalen Tumorwachstum und frühzeitiger Metastasierung ist eine modifizierte Neck dissection mit Schonung des N. accessorius, M. sternocleidomastoideus und der V. jugularis interna gerechtfertigt [38].…”

Section: Introductionunclassified

“…Sie machen ca. 8% aller Schilddrüsen-karzinome im Kindesalter aus [6]. Eine Lebensverlängerung ist nur durch eine radikale Thyreoidektomie erreichbar [27,28].…”

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