Thyroid Cancer (TC) in Children and Adolescents – surgical management

  • Background: In recent years we observed an increase of Thyroid Cancer morbidity in children and adolescents treated in Wielkopolska region. Treatment for this condition is still challenging because of lack of treatment protocols for this age group.

    Purpose: Review of surgical treatment efficacy in TC pediatric patients

    Methods: We retrospectively reviewed records of 432 patients treated for TC in years 2000-2018.The patient age was 6-18 years. Male to Female ratio was 1:5. Diagnosis was confirmed after clinical examination, ultrasonography and FNAB. We have analyzed surgical technique of TC treatment and complication rate post-op.

    Results: 368 patients had a diagnosis of unilateral or bilateral thyroid nodular goiter confirmed by histopathology exam. In 64 patients malignant thyroid cancer cases were treated surgically by total thyroidectomy and selective lymph nodes resection. After surgery J131 treatment was continued.

    52 patients had diagnosis of thyroid papillary cancer, 8 patients with thyroid follicular cancer and 4 cases with medullary thyroid cancer. Diagnosis was confirmed by FNAB in 85% of patients. Most common complications were: hypoparathyroidism 7%, recurrent laryngeal nerve palsy 1.8%, postoperative bleeding 1%, infection 0.6%. There was no thyroid nodular goiter recurrence case. Two patients had revision surgeries because of single metastatic changes in lymph nodes.

    Conclusion: Increase in TC in pediatric patients should raise awareness for GP.
    Thyroid nodular goiter is prognostic factor for malignant TC and it requires surgical treatment. Low complication rate of surgery confirm safety and efficacy of surgical treatment.

 

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