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Pediatric differentiated thyroid carcinoma: An update from the APSA Cancer Committee.

Emily R Christison-Lagay1, Reto M Baertschiger2, Catherine Dinauer1

  • 1Division of Pediatric Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar St, PO Box 208062, New Haven, CT.

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|June 20, 2020
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Summary

Pediatric differentiated thyroid carcinoma (DTC) management involves surgery, with outcomes influenced by risk factors. Emerging molecular genetics and targeted therapies offer new treatment avenues for advanced cases.

Keywords:
CancerCarcinomaFollicularPapillaryPediatricThyroid

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Area of Science:

  • Pediatric Endocrinology
  • Surgical Oncology
  • Genetics

Background:

  • Differentiated thyroid carcinomas (DTCs) are uncommon in young children but constitute a significant portion of adolescent malignancies.
  • Risk factors for pediatric DTC include nodules, family history, radiation, iodine deficiency, autoimmune thyroid disease, and genetic syndromes.

Purpose of the Study:

  • To review current surgical approaches for pediatric DTC.
  • To analyze associated complications, recurrence, and survival rates.
  • To discuss evolving treatment strategies.

Main Methods:

  • Comprehensive literature review of published articles (Level 1-5).
  • Inclusion of expert opinion (Level 5).
  • Focus on surgical therapeutic strategies.

Main Results:

  • Pediatric DTC shares epidemiological similarities with adult forms, predominantly affecting females.
  • Diagnosis and management rely on imaging (ultrasound), fine needle aspiration, and risk stratification.
  • Total thyroidectomy and lymph node resection are primary surgical treatments.

Conclusions:

  • Surgical resection remains the cornerstone for pediatric DTC.
  • Molecular genetics and targeted therapies are increasingly important for refractory or unresectable disease.
  • Long-term outcomes and recurrence patterns require ongoing evaluation.