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Differentiated follicle-derived thyroid carcinoma in children
B A Lamberg1, M Karkinen-Jääskeläinen, K O Franssila
1Third Department of Medicine, University of Helsinki, Finland.
Acta Paediatrica Scandinavica
|May 1, 1989
Summary
This study reports on differentiated thyroid carcinoma in pediatric patients, finding that 80% achieved a cure with surgery, radioactive iodine, and thyroxine therapy, with long-term survival observed.
Area of Science:
- Endocrinology
- Pediatric Oncology
- Nuclear Medicine
Background:
- Differentiated thyroid carcinoma (DTC) is a rare malignancy in children.
- Long-term outcomes and optimal treatment strategies for pediatric DTC require further investigation.
Purpose of the Study:
- To evaluate the long-term outcomes of differentiated thyroid carcinoma in pediatric patients treated between 1953 and 1984.
- To assess the efficacy of surgery, radioactive iodine, and thyroxine therapy in achieving cure and survival.
Main Methods:
- Retrospective analysis of 15 pediatric patients (aged 4-16) with DTC.
- Review of surgical procedures (total/subtotal thyroidectomy), adjuvant therapies (radioactive iodine, external irradiation), and thyroxine treatment.
- Long-term follow-up, including serum thyroglobulin (Tg) measurements.
Main Results:
- 13 papillary, 1 follicular, and 1 suspected follicular carcinoma.
- 73% had cervical lymph node metastases; 25% had pulmonary metastases.
- One patient with extensive pulmonary metastases died; 80% of patients are presumed cured with long-term follow-up (9-33 years).
- Undetectable serum thyroglobulin during thyroxine therapy in 90% of evaluated patients.
Conclusions:
- Pediatric differentiated thyroid carcinoma, even with metastases, can achieve high cure rates with comprehensive treatment.
- Surgery combined with radioactive iodine and suppressive thyroxine therapy is effective for long-term disease control.
- Serum thyroglobulin monitoring is a valuable tool for assessing treatment response and detecting recurrence.