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Papillary Carcinoma of Thyroid Gland in a Two-year-old Child
Insights
Pediatric thyroid nodules are rare but frequently malignant. This case highlights papillary thyroid carcinoma in a two-year-old without risk factors, emphasizing the need for thorough evaluation of any childhood thyroid nodule.
Area of Science:
- Pediatric Endocrinology
- Oncology
- Surgical Pathology
Background:
- Thyroid nodules are uncommon in children but have a higher malignancy rate (26%) compared to adults (5-10%).
- Identified risk factors in children include female sex, older age, prior thyroid disease, neck irradiation, and family history.
- In children under 10 without risk factors, thyroid nodule incidence is minimal.
Background:
Thyroid nodules are less common among children than among adults. By contrast, thyroid nodules are more often malignant in childhood than in adulthood. In children, 26% of thyroid nodules are malignant, while in adults the corresponding value is 5-10%. Risk factors for developing thyroid nodules in children are female sex, post-pubertal age, previous or co-existing thyroid disease, previous irradiation of the neck, and a family history of thyroid disease. In children younger than 10 years, when no risk factors are present, the incidence rates are practically negligible.
Case Report:
A two-year-old girl presented with a right thyroid mass. Laboratory evaluation revealed normal levels of triiodothyronine and thyroid-stimulating hormone. Thyroid ultrasonography revealed a 4.8 × 3.2 × 2.5 cm nonhomogenous nodule. The patient underwent right hemithyroidectomy. The pathology was consistent with papillary thyroid carcinoma; therefore, total thyroidectomy and selective neck dissection were performed.
Conclusions:
We report a very rare case of papillary thyroid carcinoma in a two-year-old child with no risk factors. The detection of a thyroid nodule in such a young child with no pre-disposing risk factors does not exclude the possibility of thyroid carcinoma and warrants careful evaluation and appropriate therapy.
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