Thyroid Papillary Carcinoma in Paediatric and Adolescent Patients: Evaluation of Surgical Treatment in a Single Centre

ABSTRACT

ABSTRACT Aim: Thyroid cancers are the most commonly determined cancers in the paediatric age group. Although the rates of lymph node and distant metastases are greater at the time of diagnosis in comparison with adult thyroid cancers, with the appropriate treatment protocols, the prognosis is excellent. In this paper, we present the clinical characteristics of thyroid papillary carcinoma determined in children and adolescents in our clinic, the surgical techniques applied and the clinical results evaluated in consideration of the relevant literature. Methods: A retrospective evaluation of 12 patient records in the paediatric and adolescent age group from a total of 250 who underwent surgery for a diagnosis of thyroid papillary carcinoma at Ankara Oncology Training and Research Hospital between 2000 and 2007. Results: The prevalence of thyroid and papillary carcinoma in childhood and adolescence was determined as 4.8%. The patients were all female with a mean age of 17.9 years (range, 11-21 years). At the time of diagnosis, lymph node metastases were identified in seven cases (58.3%) and lung metastases in four cases (33.3%). Total thyroidectomy was performed on all patients and for those with lymph node metastasis; a modified radical neck dissection was also applied. Post-operatively, all patients were administered radioactive iodine therapy followed by levothyroxine therapy. During the mean follow-up period of 123 months, apart from persistent tumour in some patients, no recurrence was noted in other patients. Conclusion: As thyroid papillary carcinoma in childhood and adolescence is characterized by lymph node and distant metastases, even if the tumour is limited to the thyroid, because of frequent recurrence after treatment, total thyroidectomy and, where necessary, modified neck dissection are recommended for all patients rather than more conservative treatment protocols.