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Published on: February 9, 2024
Pediatric differentiated thyroid carcinoma: The clinicopathological features and the coexistence of Hashimoto's
Pei-You Ren1, Jia Liu1, Shuai Xue1
1Department of Thyroid Surgery, The First Hospital of Jilin University, Jilin University, Changchun, 130021, China.
Insights
Pediatric differentiated thyroid carcinoma (DTC) shows aggressive traits like larger tumors and higher metastasis rates. While mortality is low, active treatment is crucial due to high recurrence risk in children.
Area of Science:
- Pediatric Endocrinology
- Oncology
- Pathology
Background:
- Differentiated thyroid carcinoma (DTC) in children under 18 is rare.
- Understanding its unique clinicopathological features and outcomes is essential for effective management.
- The association with Hashimoto's thyroiditis in pediatric DTC warrants further investigation.
Purpose of the Study:
- To assess the outcomes and detailed clinicopathological features of pediatric DTC.
- To investigate the relationship between Hashimoto's thyroiditis and postoperative pathological features in children with DTC.
- To compare pediatric DTC characteristics with adult populations.
Main Methods:
- Retrospective review of pediatric DTC patients (under 18 years old) over 16 years.
- Analysis of clinicopathological features and outcomes.
- Comparison with adult DTC patients (19-20 years old and 21-44 years old).
Main Results:
- Pediatric DTC demonstrated larger tumor size, higher rates of extrathyroidal extension, and more local/pulmonary metastasis compared to adult DTC.
- A high prevalence of Hashimoto's thyroiditis was observed in pediatric patients, without impacting pathological features.
- Pediatric patients had the highest rates of persistent/recurrent disease, despite low mortality.
Conclusions:
- Pediatric DTC exhibits more aggressive behavior, necessitating active treatment due to high recurrence risk.
- Low mortality in pediatric DTC contrasts with aggressive features, highlighting the need for vigilant follow-up.
- Hashimoto's thyroiditis may play a role in the pathogenesis of pediatric DTC.
Background/Objective:
The purpose of this study is to assess outcomes and the detailed clinicopathological features of differentiated thyroid carcinoma (DTC), including the relation of Hashimoto's thyroiditis and postoperative pathological features in child under 18 years old.
Methods:
We reviewed patients with DTC under 18 years old (pediatric DTC patients) seen during recent 16 years. The clinicopathological features and outcomes of pediatric DTC were analyzed by comparison with patients of 19-20 years old or 21-44 years old.
Results:
Sixty four children with DTC [median age 16 years (range, 5-18)] were studied. The ratio of female to male was 5:1, but no difference was found by comparison with adult of 21-44 years old. No difference was found in multifocality, but DTC in child showed lager tumor size (P < 0.001), higher rate of extrathyroidal extension (P = 0.017), more local or pulmonary metastasis (P < 0.001, P < 0.001 respectively) than adult thyroid carcinoma. High rate of Hashimoto's thyroiditis (19/43) without influence on pathological features was found in patients under 18 years old. No differences, except for distant metastasis, were found by comparison of clinicopathological features between patients under 18 years old and 19-20 years old. Pediatric patients possessed highest rates of persistent/recurrent disease, though only one child died.
Conclusion:
Pediatric DTC has more aggressive behavior characterized by a high rate of extrathyroidal extension, local and pulmonary metastasis. Pediatric DTC has low mortality, but active treatments are needed for the high risk of persistent or recurrent diseases. Hashimoto's thyroiditis may be associated with the pathogenesis or mechanism of pediatric DTC.
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