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Pediatric Thyroid Microcarcinoma.

Jonathan Lerner1, Melanie Goldfarb2

  • 1University of Southern California Keck School of Medicine, Los Angeles, CA, USA.

Annals of Surgical Oncology
|April 10, 2015
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Pediatric thyroid microcarcinomas (TMCs) are declining and represent less than 10% of childhood thyroid cancers. These TMCs show excellent survival rates and are often treated with partial thyroidectomy without radioiodine.

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Area of Science:

  • Pediatric oncology
  • Endocrinology
  • Cancer epidemiology

Background:

  • Thyroid microcarcinomas (TMCs) are increasingly diagnosed in adults, but their occurrence in children remains understudied.
  • Understanding pediatric TMCs is crucial due to potential differences in incidence, characteristics, and outcomes compared to adults.

Purpose of the Study:

  • To investigate the incidence, clinical characteristics, and survival outcomes of TMCs in pediatric patients.
  • To compare TMCs with larger differentiated thyroid carcinomas (DTCs) in the same age group.

Main Methods:

  • Utilized the Surveillance, Epidemiology, and End Results (SEER) registry (1988-2009) to identify pediatric DTC patients (≤19 years).
  • Classified patients into TMC (≤1 cm) and larger tumor (>1 cm) groups.
  • Compared demographic, tumor, and treatment factors, as well as overall survival (OS) and disease-specific survival (DSS).

Main Results:

  • Of 1825 pediatric DTC patients, 8.4% had TMCs; incidence decreased over the study period.
  • TMCs were more often papillary, had negative lymph nodes, and were treated with partial thyroidectomy without radioiodine.
  • No significant differences in OS or DSS were observed between TMCs and larger DTCs.

Conclusions:

  • Pediatric TMCs are declining and constitute a small fraction of childhood thyroid cancers.
  • TMCs in pediatric patients are typically managed with partial thyroidectomy and have favorable survival outcomes.
  • Follicular or Hurthle cell histology is a predictor of decreased OS in primary TMCs.