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Poorly differentiated thyroid carcinoma in a 9-year-old boy: case report
Yi-Lei Wu1, Wei-Hsin Ting, Shiuan-Li Wey
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
Journal of Pediatric Endocrinology & Metabolism : JPEM
|December 8, 2011
Summary
Poorly differentiated thyroid carcinoma (PDTC) is rare in children. A cystic nodule becoming solid and hypoechoic may indicate PDTC, requiring prompt medical attention.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Pathology
Background:
- Poorly differentiated thyroid carcinoma (PDTC) presents a significant challenge in pediatric oncology due to its rarity and aggressive nature.
- Distinguishing PDTC from other thyroid neoplasms is crucial for appropriate management and prognosis.
Observation:
- A 9-year-old boy presented with a thyroid nodule initially cystic and solid, which evolved into a completely solid, hypoechoic mass.
- Histopathological examination revealed small- to intermediate-size round cells with hyperchromatic nuclei and mitotic figures, positive for thyroid transcription factor 1 and thyroglobulin, consistent with PDTC.
Findings:
- The described PDTC case exhibited characteristics intermediate between well-differentiated and anaplastic thyroid carcinomas.
- Differential diagnosis included solid variants of papillary carcinoma and follicular carcinoma with predominantly solid/trabecular patterns.
Implications:
- The transformation of a cystic thyroid nodule to a solid, hypoechoic state in a child warrants high suspicion for malignancy, specifically PDTC.
- Multimodal treatment, including surgery, radioactive iodine therapy, and hormone suppression, was employed, highlighting the complex management of pediatric PDTC.
