Related Experiment Video
Updated: Aug 16, 2026
Establishment and Characterization of Patient-Derived Xenograft Models of Anaplastic Thyroid Carcinoma and Head and Neck Squamous Cell Carcinoma
Published on: June 2, 2023
Papillary thyroid carcinoma in children: risk factors and complications of disease recurrence
Brian A Palmer1, Abdalla E Zarroug, Rainer N Poley
1Mayo Medical School, Mayo Clinic College of Medicine Rochester, MN 55905, USA.
Insights
Recurrent papillary thyroid carcinoma (PTC) in children is best treated with thyroid resection and radioactive iodine. Lymph node involvement and multiple nodules predict recurrence risk in pediatric PTC.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Surgical Oncology
Background:
- Recurrent papillary thyroid carcinoma (PTC) in children presents treatment challenges.
- Optimal management strategies for pediatric recurrent PTC require further elucidation.
Purpose of the Study:
- To identify risk factors, optimal treatments, complications, and prognosis for recurrent PTC in pediatric patients.
- To evaluate the effectiveness of surgical resection and radioactive iodine ablation for recurrent PTC.
Main Methods:
- Retrospective review of pediatric patients (≤18 years) with PTC undergoing thyroid resection between 1987 and 1999.
- Analysis of initial presentation, surgical procedures, recurrence rates, and complications.
Main Results:
- Recurrence developed in 47% of pediatric PTC patients, particularly those with lymph node involvement and multiple nodules.
- Total thyroidectomy was associated with higher recurrence rates compared to subtotal thyroidectomy.
- Complications included permanent hypocalcemia and recurrent laryngeal nerve injury, primarily after total thyroidectomy.
Conclusions:
- Thyroid resection with selective radioactive iodine ablation is a safe and effective treatment for recurrent pediatric PTC.
- Lymph node involvement and multiple thyroid nodules are significant predictors of recurrent disease in children.
Introduction:
Optimal treatment of recurrent papillary thyroid carcinoma (PTC) in children remains controversial. We reviewed our experience with recurrent PTC to better identify children diagnosed with it.
Aims:
The objective of this study was to determine the risk factors, optimal treatment, complications, and prognosis of recurrent PTC in children.
Methods:
This is a retrospective review of all thyroid resections for children aged 18 years or younger who have PTC at a single institution from 1987 to 1999.
Results:
Thirty-six children, 7 boys (19%) and 29 girls (81%), underwent initial cervical exploration for PTC. Lymph node involvement was noted in 25 patients (69%); however, there was no distal disease. An equal number of children underwent subtotal thyroidectomy (n = 18) and total (n = 18) thyroidectomy as their initial operation. Papillary thyroid carcinoma recurrences developed in 17 patients (47%) a median of 7 months (range, 1-43 months) after their initial operation. Recurrence was more common for patients with lymph node involvement (P < .01) and multiple nodules (P < .05) at presentation. Recurrence developed in 5 patients after subtotal thyroidectomy and in 12 patients after total thyroidectomy. Sixteen children with recurrent PTC had a second operation and 6 required a third operation. Total operative complications included 2 patients with permanent hypocalcemia and 1 patient with permanent recurrent laryngeal nerve injury, all of whom had a total thyroidectomy. No patient died; however, 3 continue to harbor disease. Mean follow-up for patients with PTC was 65 months (range, 15 to 144 months).
Conclusions:
Thyroid resection combined with selective use of radioactive iodine ablation is a safe and effective treatment for recurrent PTC in children. The best predictors of this recurrent disease are lymph node involvement and multiple thyroid nodules at presentation.
Related Concept Videos
01:27Hyperthyroidism II: Pathophysiology
01:28Graves' Disease I: Introduction
01:24Graves Disease II: Pathophysiology
01:20The Retinoblastoma Gene
The first-ever tumor suppressor gene called Rb was identified in retinoblastoma - a rare eye tumor in children. In inherited forms of the disease, a child inherits one defective copy of the Rb gene, which predisposes them to retinoblastoma. However,...
02:07Tumor Progression
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
01:30Skin Cancer
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...