Imaging and Clinical Features of Thyroid Cancer in Children and Adolescents

Abstract

Purpose: To evaluate clinical and imaging features of pediatric thyroid cancer, including BRAF V600E mutation status in papillary thyroid cancer (PTC). Materials and Methods: We evaluated clinical findings including BRAF V600E status, ultrasound (US), and CT features of 13 pediatric patients with thyroid cancer. US findings were retrospectively analyzed for location, presence of a nodule, echotexture, echogenicity, calcifications, margin, shape, intranodular vascularity and abnormal lymph nodes. CT characteristics of the lesions, including attenuation, calcification, and measured degree of enhancement, were assessed. Results: The patients included three boys and ten girls with a mean age of 15.5 years (range 6-18 years). No patient was exposed to radiation. Palpable neck mass was the most common presentation. Eleven of 13 patients (84.6%) were diagnosed with PTC, and two (15.4%) had follicular thyroid cancer (FTC). Nine of 13 (69.2%) had high Tstaging. BRAF V600E mutations were detected in 30.0% of PTC patients. A diffusely enlarged thyroid with calcifications (n = 2) or nodules (n = 7) was detected on US. All PTC nodules showed malignant US findings and one FTC displayed on indeterminate nodule. Nodules generally showed low attenuation on enhanced CT (n = 11/12). Conclusion: US demonstrated enlarged glands with calcifications or nodules. Diffusely enlarged thyroids with microcalcifications should be evaluated using fine-needle aspiration. A low attenuation nodule was a common finding on enhanced CT.

Ultrasonography of Various Thyroid Diseases in Children and Adolescents: A Pictorial Essay

“…Metastatic nodes are characterized by a round shape, asymmetrical cortical thickening, hyperechogenecity, multiple punctate calcifications, cystic changes, loss of fatty hilum, or increased vascularity on color Doppler imaging ( 29 ). The reasons for the variations between children and adults are unknown, but are generally thought to be due to differences in mutations and oncogene expression in the thyroid ( 30 , 31 ).…”

“…In addition to suspicious malignant nodules, a diffusely enlarged thyroid with numerous microcalcifications on US is defined as a thyroid malignancy and should be evaluated using fine-needle aspiration (FNA) biopsy with a BRAF analysis ( 31 ).…”

“…The frequency of the BRAF mutation increases with age. The prevalence of the BRAF mutation in Korean children (30-50%) is lower than that in adults (70-83%) ( 31 , 33 ).…”

Thyroid Ultrasound: State of the Art. Part 2 – Focal Thyroid Lesions

“…In addition to suspicious malignant nodules, a diffusely enlarged thyroid with numerous microcalcifications on US is defined as a thyroid malignancy and should be evaluated using FNA [8].…”

Multisetting Greenberger-Horne-Zeilinger theorem

“…They can be realized with multiport beam splitters (see Refs. [12,14,19,20]). GHZ-type contradictions find applications in various quantum information tasks, especially in variations of secret sharing protocols [21], and reduction of communication complexity [22].…”