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A twenty-year experience with thyroid carcinoma in children
J G Desjardins1, J Bass, G Leboeuf
1Department of Surgery, Ste-Justine Hospital, University of Montreal, Quebec, Canada.
Journal of Pediatric Surgery
|August 1, 1988
Summary
This study on pediatric thyroid carcinoma found that all 23 patients are alive and disease-free after treatment. A conservative approach for well-differentiated thyroid cancer and total thyroidectomy for medullary thyroid cancer proved effective.
Area of Science:
- Endocrinology
- Pediatric Oncology
- Surgical Oncology
Background:
- Thyroid carcinoma in children is rare but requires specific management strategies.
- Long-term outcomes and optimal surgical approaches for different thyroid cancer subtypes in pediatric patients are crucial.
- Understanding the incidence and characteristics of pediatric thyroid cancer aids in refining treatment protocols.
Purpose of the Study:
- To evaluate the long-term outcomes of pediatric patients treated for various types of thyroid carcinoma.
- To assess the effectiveness of different surgical approaches (partial vs. total thyroidectomy) based on carcinoma subtype.
- To investigate the role of early detection methods for familial medullary thyroid carcinoma.
Main Methods:
- Retrospective analysis of 23 pediatric patients with thyroid carcinoma treated over 20 years.
- Categorization of tumors into papillary, follicular, and medullary thyroid carcinoma.
- Surgical management included partial thyroidectomy for well-differentiated types and total thyroidectomy for medullary type.
- Follow-up assessments monitored disease progression and complications.
Main Results:
- All 23 patients remain alive with no evidence of progressive disease.
- Papillary (11) and follicular (4) carcinomas were treated with partial thyroidectomy; medullary (8) with total thyroidectomy.
- Average follow-up was 7.5 years for well-differentiated and 4.3 years for medullary carcinomas.
- Complications (hypoparathyroidism, tracheostomies) occurred mainly after secondary neck explorations.
Conclusions:
- A conservative surgical approach for well-differentiated thyroid carcinoma and total thyroidectomy for medullary thyroid carcinoma are supported by these findings.
- Early detection of familial medullary thyroid carcinoma via pentagastrin stimulation can lead to more effective therapy.
- The study supports current management strategies for pediatric thyroid carcinoma, emphasizing subtype-specific surgical treatment.