Pediatric thyroid cancer: a retrospective analysis of 42 cases

Pediatric thyroid cancer is rare. This study summarizes the clinical characteristics, treatment modalities, and therapeutic outcomes of pediatric and adolescent patients (≤18 years) with this malignancy treated at our institution. A retrospective analysis was conducted on 42 patients who underwent surgical treatment between 2018 and 2023. The cohort was predominantly female, comprising 34 girls and 8 boys. Postoperative histopathological analysis revealed 35 cases of papillary carcinoma, 4 of follicular carcinoma, and 1 each of mixed papillary-follicular carcinoma, medullary carcinoma, and poorly differentiated carcinoma. In 26 cases (61.9%), tumors exceeded 2 cm in diameter. The cervical lymph node metastasis rate was 76.2% (32/42), with 6 cases (14.3%) exhibiting lung metastasis. Surgical intervention was determined based on lesion characteristics and lymph node status. As of October 2025, patient follow-up ranged from 24 to 94 months, with a median duration of 61 months. Three patients (7.1%) underwent repeat neck dissection for recurrent cervical lymph node disease. No deaths occurred during the median follow-up period of 61 months. Statistical analysis suggested that extrathyroidal invasion is a significant factor influencing cervical lymph node metastasis in thyroid cancer, whereas bilateral involvement, multifocality, and extrathyroidal invasion are prominent indicators of lung metastasis. In summary, pediatric thyroid cancer predominantly affects females. Papillary carcinoma is the primary histological type, with tumors tending to be larger in diameter and exhibiting high rates of cervical lymph node and pulmonary metastasis. Nonetheless, with aggressive treatment, the overall prognosis remains favorable.