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Differentiated thyroid cancer.

Ajay Kumar1, C S Bal

  • 1Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.

Indian Journal of Pediatrics
|November 19, 2003
PubMed
Summary
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Differentiated thyroid cancer in children is aggressive, especially in younger children, but radioiodine therapy significantly improves outcomes. Long-term survival for pediatric differentiated thyroid carcinoma is good despite aggressive presentation.

Area of Science:

  • Pediatric Oncology
  • Nuclear Medicine
  • Endocrinology

Background:

  • Differentiated thyroid carcinoma (DTC) in children and adolescents is rare but often presents aggressively.
  • Understanding the unique clinical course and treatment outcomes in pediatric DTC is crucial for effective management.

Purpose of the Study:

  • To analyze the presentation, clinical course, and radioiodine therapy outcomes in pediatric differentiated thyroid carcinoma.
  • To define the specific characteristics and treatment efficacy of DTC in patients aged 20 years or younger.

Main Methods:

  • Retrospective analysis of 122 pediatric patients (age ≤20 years) with DTC treated between 1967-2002.
  • Evaluation of disease presentation, including tumor size, lymph node involvement, and distant metastases.

Related Experiment Videos

  • Assessment of radioiodine-131 (131I) therapy effectiveness, including ablation rates and cumulative doses.

    • Main Results:

    • DTC in this pediatric cohort showed aggressive features, with 64% having lymph node involvement and 23% distant metastases.
    • Radioiodine therapy achieved high ablation rates: 94% for residual thyroid, 88% for nodal metastases, and 71% for pulmonary metastases.
    • Overall, 87% of patients were disease-free at follow-up, with a low mortality rate of 2.5%, predominantly in younger children (<10 years).

    Conclusions:

    • Pediatric differentiated thyroid carcinoma is aggressive, with behavior varying by age, particularly in children under 10.
    • Post-surgical radioiodine ablation is an effective adjuvant therapy for pediatric DTC, leading to good long-term survival.
    • Despite aggressive initial presentation, the prognosis for children and adolescents with DTC is generally favorable with appropriate treatment.