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Evaluation of children with medullary thyroid carcinoma
A Libroia1, F Muratori, U Verga
1Department of Endocrinology, Niguarda Hospital, Milan, Italy.
Insights
Early diagnosis and surgery for pediatric medullary thyroid carcinoma (MTC) are crucial. Prognosis in children with MTC depends on the disease extent at diagnosis and treatment initiation.
Area of Science:
- Pediatric Endocrinology
- Surgical Oncology
- Thyroid Cancer Research
Background:
- Medullary thyroid carcinoma (MTC) in children requires prompt diagnosis and treatment.
- Metastatic spread is a significant concern in pediatric MTC cases.
Purpose of the Study:
- To evaluate the long-term outcomes of early diagnosis and surgical intervention for MTC in pediatric patients.
- To determine the factors influencing the prognosis of MTC in children.
Main Methods:
- Retrospective analysis of eight pediatric MTC patients treated between 1981 and 1991.
- Seven patients underwent total thyroidectomy with varying follow-up periods (14 months to 10 years).
- Assessment of basal and stimulated calcitonin (CT) levels pre- and post-operatively.
Main Results:
- Four patients presented with a neck mass and elevated basal calcitonin (CT).
- Three of these four patients experienced recurrent disease post-surgery.
- In three other patients, diagnosis was delayed, identified through screening with stimulated CT tests.
- All patients achieved normal stimulated CT values postoperatively.
Conclusions:
- The extent of medullary thyroid carcinoma at diagnosis significantly impacts the prognosis in children.
- Early detection and surgical treatment are vital for improving outcomes in pediatric MTC.
Abstract:
Early diagnosis and surgical treatment of medullary thyroid carcinoma (MTC) in children is essential to decrease the likelihood of metastatic spread. From 1981 to 1991, eight children under 18 years of age (five girls and three boys) with MTC were seen and seven underwent total thyroidectomy. Follow-up ranged from 14 months to 10 years after surgery. Four of the seven presented with a neck mass and elevated basal levels of calcitonin (CT). After surgery, three had recurrent disease. In the other three, the diagnosis was made after several years of screening (normal basal values of CT but increased CT levels after calcium/pentagastrin infusion). All had normal stimulated CT values postoperatively. This follow-up showed that the prognosis for MTC in children depends predominantly upon its extent at the time of the diagnosis and treatment.