Thyroid carcinoma in children and adolescents: Clinical characteristics and follow-up from two centers

The aim of this study was to analyze the clinical features and outcomes of thyroid carcinoma (TC) in children and adolescent population treated in our institution.

We gathered 43 TC patients 18 years of age or under initial diagnosed between 2009 and 2010 from two hospitals. Patient's clinical characteristics, laboratory tests, and outcomes were collected and analyzed.

(1) The incidence of TC is higher in women (2.4 vs. 1.6). Papillary carcinoma accounted for the major type (67.4%). There was significant difference in tumor number, extra thyroidal invasion, and distant metastasis when compared with the children group (P < 0.05). There were higher proportions of patients with lymph node metastasis (LNM) and radioiodine therapy in adolescent patients. (2) Thyroid peroxidase antibody, thyroglobulin, thyroglobulin antibody, and urine iodine had higher levels as compared to the normal reference range. Moreover, FT3 and urine iodine showed statistical significances in adolescent group (P < 0.05). (3) Papillary carcinoma and medullary TC are more likely to have LNM extrathyroidal invasion. (4) No significant differences were seen in recurrence rate or survival rate. Pulmonary metastasis was the most common way of cancer metastasis.

The initial workup is crucial in determining benign from malignant lesions. Surgery is the most effective therapy even if it is associated with more complications in children. There is an extremely good prognosis for pediatric TC even distant metastasis happens.