Autoimmune thyropathies: a possible predisposing factor for the insurgence of PTC in Sardinian children and adolescents. A report of 55 cases.

  • Background/Purpose
    The clinical and pathological findings in pediatric thyroid carcinomas diagnosed in Sardinian children and adolescents in our Institut is here reported.

    Methods
    We recruited 55 patients aged 11-20 years old, (43 females, 12 males), underwent total thyroidectomy for thyroid cancer between January 2001 and July 2017 in our hospital. Lymphadenectomy was performed in patients with ultrasonographic evidence of enlarged lymphnodes. No risk factor, including external radiation, or family history of thyroid cancer was present in any patients.

    Results
    All cases were follicular-derived differentiated carcinomas: 38 papillary thyroid carcinomas (PTCs) (14 aggressive variants), 11 follicular carcinomas (FCs), 6 non-invasive follicular thyroid neoplasms with papillary-like nuclear feature (NIFTPs). 13 cases showed extrathyroid extension. Signs of autoimmune thyropaty were detected in 29 (23 Hashimoto Thyroiditis, 6 Basedow disease) out of the total cases and in 24 (18 Hashimoto Thyroiditis and 6 Basedow disease) out of 38 PTCs (63.2%). Cervical lymph node metastases were present, at presentation, in 21; no distant metastasis was found.

    Discussion & Conclusion
    Our study shows that thyroid cancer in Sardinian children and adolescents shows peculiar features: 1) Follicular-derived differentiated thyroid cancer represents 100% of our cohort; 2) PTC shows an incidence (69.1%) higher than that reported in the literature (1); 3) PTC is associated in the majority of cases (63.2%) with autoimmune thyropathies. This finding, together with the absence of any exposure to radiation, indicates autoimmune thyropathies as a possible predisposing factor for the insurgence of PTC in Sardinian children and adolescents not exposed to massive radiation.

 

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