Ercan, Oya1; Dagdeviren Cakir, Aydilek1; Tahmiscioglu Bucak, Feride2; Turan, Hande1; Kabasakal, Levent3;Evliyaoglu, Olcay1
1 Di vision of Pediatric Endocrinology,Department of Pediatrics, Cerrahpasa Faculty of Medicine,Istanbul University, Istanbul, Turkey
2 Bagcilar Research and Training Hospital, Istanbul,Turkey
3 Department of Nuclear Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
Background/Purpose: Thyroid cancer is the most common endocrine malignancy of childhood. Pediatric thyroid cancers have more tendency for locoregional and distant metastases at the time of diagnosis and recurrence than adults. Our aim is to evaluate clinical features and treatment modalities of patients with thyroid cancer.
Method: Clinical records of 25 patients with thyroid cancer admitted between 2001-2016 were retrospectively reviewed.
Results: Among the patients 88% were female(n=22). Mean age at the admission was 10,31± 3,9 years. Initial clinical manifestation was palpable thyroid lump in 92%, dysphonia(12%), weight loss(4%) and cough(4%). Papillary thyroid cancer(PTC) was diagnosed in 76%(n=19) (%36 follicular variant, %40 classic type), follicular thyroid cancer(FTC) in 16%, hurthle cell neoplasm in 4%. Medullary thyroid cancer was diagnosed in one patient as a component of MEN 2A. The tumor size was >1cm in all patients. Nodal involvement occurred in 68% and distal metastasis(lung) in 12%. Total thyroidectomy, lobectomy, total thyroidectomy with neck dissection was performed in 44%, 4% and %52 respectively. Transient and permanent hypoparathyroidism developed in 12%, 44% respectively. Vocal cord palsy developed unilaterally in one(4%) and bilaterally in two(8%). All patients with differentiated thyroid cancer except one, who had minimally invasive FTC, received radioactive iodine(RAI). Repetitive doses of RAI were given to 28% for local and %8 for local and distant metastasis. All patients with distal metastasis had PTC with tumor size( >4cm).
Conclusion: Pediatric thyroid cancer has high risk for local and distant metastasis. The management of patients requires multidisciplinary team effort by experienced professionals