Thyroid Cancer in Childhood

Doci, Roberto; Pilotti, Silvana; Costa, Alberto; Semeraro, G; Cascinelli, Natale

doi:10.1177/030089167806400613

Cited by 11 publications

(3 citation statements)

References 22 publications

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“…In Marshallese, exposed to a mixture of radioiodines and gamma radiation, thyroid malignancies were detected 10-21 years after the nuclear explosion [18]. Various studies of childhood thyroid cancers after exposure of the head and neck to external irradiation demonstrate a latent interval of 3.5-18 years, with the average time between X-ray therapy and tumor development varying from 6.3 to 9.6 years [19][20][21][22][23]. The National Council of Radiation Protection and Measurement recommends using a minimum induction period of 5 years in the calculation of risk of radiation-induced thyroid cancer [24].…”

Section: Discussionmentioning

confidence: 99%

Childhood Thyroid Cancer: Comparison of Japan and Belarus.

et al. 1998

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Abstract. The high incidence of childhood thyroid cancer in Belarus is suspected to be due to radiation exposure after the Chernobyl reactor accident. To clarify the clinical and histological characteristics of childhood thyroid cancer in Belarus, we therefore compared these patients to a radiation non-exposed control series in Japan. In Belarus, 26 thyroid cancers in subjects aged 15 or younger were diagnosed among 25,000 screened between 1991 and 1995 by Chernobyl-Sasakawa Health and Medical Cooperation Project. The clinical and morphologic features of these 26 cases were compared to 37 childhood thyroid cancers in Japan diagnosed between 1962 and 1995. The age distribution at operation in Belarus showed a peak at 10 years old, with a subsequent fall in numbers. In contrast, the age distribution at operation in Japan showed a smooth increase between the ages of 8 and 14. The mean tumor diameter was smaller in Belarus than that in Japan (1.4 ± 0.7 vs. 4.1 ± 1.7 cm, P<0.001). The sex ratio, regional lymph node metastasis, extension to surrounding tissues or lung metastasis did not differ significantly. Histologically, all cases in Belarus were papillary and in Japan 33 cases were papillary and 4 cases were follicular carcinomas. Among papillary carcinomas, the frequency of a solid growth pattern, a criteria for classifying a tumor as poorly differentiated, was higher in Belarus than that in Japan (61.5 vs.18.2%, P<0.001). The difference between the features of childhood thyroid cancer in Japan and Belarus may be due to the difference in the process of carcinogenesis, but more direct evidence and further analysis by molecular epidemiology are needed in Belarussian cases.

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Section: Discussionmentioning

confidence: 99%

Childhood Thyroid Cancer: Comparison of Japan and Belarus.

et al. 1998

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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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“…PTCs in childhood and adolescence are reportedly characterized by an excellent overall survival (OS), nearing 100%, despite a strong tendency for loco‐regional and distant spread, with very high percentages of invasion beyond the thyroid capsule into the soft tissue of the neck, distant metastases, and recurrences, whereas these prognostic factors negatively characterize the outcome in adult PTC, particularly in the high‐risk, poorly differentiated forms 2–6. If Chernobyl series are excluded, the literature contains only a few large series of PTCs of childhood and adolescence with a long‐term follow‐up 1,7,8–13. Our aim was to evaluate our clinicopathological and follow‐up data on a series of 42 consecutive patients with PTC aged 0–17 years treated at our institution over a 30‐year period, whose histological material was available for review and whose clinical data at onset and during follow‐up were complete.…”

Section: Introductionmentioning

confidence: 99%