Differentiated thyroid carcinomas in children and adolescents.

Area of Science:

• Pediatric Oncology
• Endocrinology
• Cancer Research

Background:

• Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy in children and adolescents.
• Understanding the specific characteristics and treatment outcomes in this age group is crucial for optimizing patient care.

Purpose of the Study:

• To analyze the incidence, clinical presentation, treatment, and outcomes of differentiated thyroid carcinomas in pediatric and adolescent populations.
• To evaluate the effectiveness of radioiodine therapy and identify factors influencing treatment resistance and recurrence.

Main Methods:

• Retrospective analysis of pediatric and adolescent patients diagnosed with differentiated thyroid cancer.
• Review of clinical data including incidence, demographics, presentation, nodal and lung metastases, treatment modalities (radioiodine), and follow-up outcomes.
• Statistical evaluation of ablation rates, recurrence, and mortality.

Main Results:

• DTC accounted for 3.05% of all differentiated thyroid cancers, with a female predominance.
• Papillary, follicular, and mixed histology were equally represented; no cases occurred in children under 10.
• 50% presented with nodal metastases, 15% with lung involvement; 70% received radioiodine therapy.
• Radioiodine achieved 86% ablation after two doses, with higher resistance in cases with lung and nodal metastases.
• Recurrence rate was 8.5%, exclusively in regional nodes, with no recorded mortality.

Conclusions:

• Differentiated thyroid carcinoma in children and adolescents requires specific management strategies.
• Radioiodine therapy is highly effective, but careful monitoring is needed for patients with advanced disease (nodal/lung metastases).
• Long-term follow-up is essential to manage regional recurrences, as mortality is low.