Clinical Course and Outcome of Thyroid Carcinoma in Childhood / 대한소아내분비학회지

ABSTRACT

PURPOSE: Thyroid carcinoma is rarely occurred in childhood and has a good prognosis despite high incidence of relapse. This study was undertaken to investigate clinical, histological characteristics and prognosis of thyroid carcinoma in childhood. METHODS: Eleven patients (6 males and 5 females) less than 21 years of age were enrolled in this study. They have been followed up for a mean duration of 6 years, ranging from 0.4 to 11 years. Clinical characteristics including age at diagnosis, sex, histological type, tumor size, metastasis, staging, treatment modality, outcome and prognosis with thyroid carcinoma in childhood were reviewed retrospectively. RESULTS: The mean age at diagnosis was 11.6+/-2.84 years. The predominant type of histology was papillary carcinoma (82%). Serum thyroglobulin levels were elevated up to 203.6+/-151.17 ng/mL in all patients at diagnosis. A thyroid scan using 99mTc-pertechnetate revealed cold (64%), warm (9%) and hot (18%) nodules. Seven patients (64%) had lymph node metastases, and five patients (45%) had pulmonary metastases at diagnosis. Total or near total thyroidectomy was performed in seven (64%) patients with local or distant metastases. Unilateral lobectomy was performed in four (36%) patients without metastases. Seven (64%) patients with local or distant metastatic lesions have been under radioiodine (131I) ablation therapy. Four (57%) out of seven patients improved, and three (43%) patients were persistent. CONCLUSIONS: Prognosis of thyroid carcinoma in childhood was good despite high incidence of local or distant metastasis. Patients with thyroid carcinoma should be diagnosed early because different treatment modalities and prognosis of patients with thyroid carcinoma could be determined by the presence of metastatic lesion and histological type.