[Carcinoma of the thyroid gland in childhood]

In a surgical series of 54 carcinomas of the thyroid in children under 15 years of age (22 males, 32 females), differentiated carcinoma was disclosed in 50 cases. Of these, the pattern was purely papillary in 5, purely follicular in 3 and mixed, i.e. papillary and follicular, in 42 cases. There was an admixture of a solid component in 25 of the mixed cases. In one case the tumour was solid medullary carcinoma with amyloid and 3 cases appeared to be anaplastic carcinomas. In 21 cases the material available for microscopical examination was both that of the primary focus and of a metastasis. In only 2 of such cases the pattern was identical in the primary carcinoma showed a purely follicular pattern in the metastases. In the remaining 18 cases the primary carcinomas appeared as structurally uniform but showed an admixture of the other differentiated component or of a solid one in the metastases. The reverse also occurred in some cases. Therefore it appears to be impossible to assess the pattern of the primary growth from its metastasis. No essential difference was disclosed in the tendency of histologically different neoplasms to metastasize. During orientational histological examination of the removed glands intrathyroidal metastases were revealed in 66%. The discrimination between the two extreme and consequently even the mixed variety of differentiated carcinomas is of no practical significance in childhood because there is no obvious correlation between the histological pattern and formation of metastases, as well as between histology and induction of hormonal function. Age and sex seems to play a more significant role in the biological behaviour in children. The incidence of carcinoma is higher in females, whereas the biological behaviour seems to be worse in males.