Differentiated thyroid carcinomas in childhood: clinicopathologic results of 26 patients

Abstract

Epithelial solid tumors which are rare in childhood are responsible for about 9 % of all childhood cancers. However, differentiated thyroid carcinomas (DTCs) are the most common of the endocrine neoplasia (0.5 % -3 % ) in all childhood malignancies. Pediatric thyroid cancers have some clinicopathological differences from adult thyroid cancers. This analysis investigates the clinical behavior and pathological characteristics of childhood thyroid cancers, with treatment options and outcomes. A total of 26 patients who had been diagnosed as having differentiated thyroid cancer when they were younger than 18 years old, and who took radioiodine ablation treatment, were included in this analysis. The incidence of multifocality, capsule invasion and lymph node metastasis were calculated as 11.5 % , 42.3 % and 53.8 % , respectively. At the 6th month, an absence of I-131 uptake in the neck, with a serum thyroglobulin (Tg) level < 1 ng/mL in the T4 off state, was accepted as the criterion for ablation of thyroid remnant. The mean follow-up period was 20.4 months (range 6 months -5 years). As a result, 19 patients were ablated with a single dose of I-131 (2 -4 GBq). A total of 6 patients took a second dose of radioiodine treatment for lymph node or distant metastases. One of these patients was 6 years old and had recently received ablation. He had diffuse lung metastasis, which was detected on the 6th day post ablation with whole body scintigraphy, and he is now under follow-up. Successful surgery and an effective radioiodine ablation have a crucial role in good outcomes of childhood DTCs.

Nuclear Medicine in Thyroid Diseases in Pediatric and Adolescent Patients

“…Histopathology of childhood DTC is classified as papillary or follicular. Papillary thyroid cancer is the most frequent histopathological diagnosis in children worldwide and in Turkey ( 49 , 50 ). Tumor size is generally greater than adult tumors.…”