Related Experiment Video
Updated: Jun 27, 2026
Spontaneous Murine Model of Anaplastic Thyroid Cancer
Published on: February 3, 2023
Metastatic insular thyroid carcinoma in the pediatric patient
Kimberly A Donnellan1, Jeffery D Carron, Steven A Bigler
1Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA. kdonnellan@ent.umsmed.edu
Insights
Metastatic insular thyroid carcinoma in children is rare. Aggressive surgery and radioactive iodine treatment are crucial for managing this pediatric thyroid cancer.
Area of Science:
- Endocrinology
- Pediatric Oncology
- Surgical Oncology
Background:
- Pediatric thyroid carcinoma is uncommon, with rare variants presenting aggressive clinical courses.
- Insular thyroid carcinoma, a subtype of follicular cell-derived thyroid cancer, is exceptionally rare in pediatric populations.
Observation:
- A 4-year-old female presented with symptoms suggestive of advanced metastatic disease, including chronic cough, dyspnea, and weight loss.
- Cervical lymph node biopsy confirmed metastatic thyroid carcinoma, with imaging indicating miliary spread to the lungs.
Findings:
- The patient underwent extensive surgical resection, including total thyroidectomy and bilateral neck dissections, with sacrifice of the right internal jugular vein and recurrent laryngeal nerve due to tumor invasion.
- Pathologic examination revealed papillary thyroid carcinoma with insular features and bilateral regional metastasis.
- Postoperative treatment included radioactive iodine (I 131) therapy.
Implications:
- Pediatric metastatic insular thyroid carcinoma necessitates a multimodal treatment approach, emphasizing aggressive surgical intervention.
- Adjuvant radioactive iodine therapy plays a critical role in managing residual disease and improving outcomes in pediatric patients.
- This case highlights the importance of early diagnosis and aggressive management for rare pediatric thyroid malignancies.
Objectives:
The clinical history of a pediatric patient with metastatic insular thyroid carcinoma will be reviewed. Previously reported cases will be examined to allow for comparison of prognosis.
Methods:
A 4-year-old female with the complaint of chronic cough, progressive shortness of breath, and weight loss for 2 months underwent cervical lymph node biopsy. The biopsy revealed metastatic thyroid carcinoma. Preoperative imaging was suspicious for miliary metastatic spread to the lungs.
Results:
Surgical intervention included total thyroidectomy with bilateral paratracheal and modified radical neck dissections. The right internal jugular vein and recurrent laryngeal nerve were removed at the time of surgery because of gross tumor invasion. Final pathologic finding revealed papillary thyroid carcinoma with insular variant features and bilateral regional metastasis. Postoperatively, the patient underwent radioactive iodine I 131 treatment.
Conclusion:
Pediatric metastatic insular thyroid carcinoma is an uncommon form of thyroid malignancy requiring aggressive surgical treatment and adjuvant radioactive iodine.
