Thyroid Microcarcinoma in Pediatric Population in Romania

Area of Science:

• Endocrinology
• Pediatric Oncology
• Cancer Epidemiology

Background:

• Non-medullary thyroid cancer (TC) is the most common endocrine malignancy, with increasing incidence largely due to rising thyroid microcarcinoma (mTC) rates.
• Thyroid microcarcinoma (mTC), defined as ≤1 cm thyroid carcinoma, is rare in children, with no specific treatment guidelines.
• Factors like the Chernobyl accident and iodine deficiency may contribute to rising TC incidence in Romania.

Purpose of the Study:

• To characterize the clinical presentation and outcomes of pediatric mTC cases in Romania.
• To analyze the incidence and trends of mTC within the Romanian pediatric population from 2000 to 2018.

Main Methods:

• Retrospective analysis of pediatric patients diagnosed with differentiated thyroid cancer (papillary and follicular) in Romania between January 1, 2000, and December 31, 2018.
• Identification and classification of mTC cases based on WHO criteria (≤1 cm).

Main Results:

• Out of 77 pediatric differentiated thyroid cancer cases, 20 (19.4%) were classified as mTC.
• Pediatric mTC constituted approximately one-fifth of all diagnosed pediatric thyroid cancers in Romania over the study period.
• The majority of mTC cases occurred in adolescents aged 15-18 years; outcomes showed high remission and survival rates despite some unfavorable local tumor phenotypes.

Conclusions:

• Pediatric mTC in Romania, while rare, represents a significant proportion of childhood thyroid cancers and generally has favorable outcomes.
• The study highlights heterogeneity in clinical practice for pediatric mTC, emphasizing the need for multicenter international studies.
• Collaborative efforts through platforms like European Reference Networks (ERN), specifically Endo-ERN, are crucial for establishing evidence-based protocols for pediatric mTC.