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Hashimoto's Thyroiditis and the Risk of Papillary Thyroid Cancer in Children
Jean-Nicolas Gallant1, Vivian L Weiss2, Sheau-Chiann Chen3
1Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Insights
Children with Hashimoto's thyroiditis (HT) are more likely to have pediatric thyroid cancer, specifically papillary thyroid carcinoma (PTC). This association is subtype-specific but does not impact survival rates.
Area of Science:
- Pediatric Endocrinology
- Oncology
- Immunology
Background:
- The link between Hashimoto's thyroiditis (HT) and pediatric thyroid cancer lacks extensive research, with most existing studies focusing on adults.
- Larger-scale studies in pediatric populations are needed to clarify this association.
Purpose of the Study:
- To investigate the relationship between Hashimoto's thyroiditis and the occurrence of thyroid cancer in pediatric patients.
- To determine if HT influences the type or prognosis of thyroid cancer in children.
Main Methods:
- A retrospective analysis of pediatric patients undergoing thyroidectomy for neoplasms over a 20-year period.
- Evaluation of patient demographics, HT diagnosis, cancer type, and survival data.
Main Results:
- Of 153 pediatric patients, 23% had HT. Patients with HT were more likely to have malignant neoplasms, particularly papillary thyroid carcinoma (PTC).
- A specific association was observed between HT and certain subtypes of PTC, but survival rates were similar between patients with and without HT.
Conclusions:
- Pediatric patients with thyroid malignancy, especially PTC, have a higher likelihood of co-existing Hashimoto's thyroiditis.
- The association between HT and pediatric PTC is subtype-specific and does not appear to affect patient survival outcomes.
Abstract:
The association between Hashimoto's thyroiditis (HT) and pediatric thyroid cancer is controversial. Most studies examining this connection have been based on adults, and larger studies in children are lacking. We performed a retrospective study of all sequential pediatric patients who underwent a thyroidectomy for a neoplasm at our institution over a twenty-year period in order to explore the link between HT and pediatric thyroid cancer. A total of 153 patients, median age 16.5 (interquartile range [IQR] 14.2-18.3) years, underwent thyroid surgery for a neoplasm. Patients were mainly female (80%) and White (84%). Median follow-up was 58.6 (IQR 20.7-105.4) months. Thirty-five (23%) patients had HT. Patients who underwent thyroid surgery and had HT were more likely to harbor a malignant neoplasm (p = 0.05); specifically, papillary thyroid carcinoma (PTC, p = 0.02). There was a difference in the distribution of HT among the subtypes of PTC (p = 0.03). Despite this, there was no difference in terms of survival between patients with/without HT. In conclusion, children with a thyroid malignancy, specifically, PTC, are more likely to have HT. The association between HT and pediatric PTC appears to be subtype-specific but does not seem to affect patient survival.
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