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CC BY-NC-ND 4.0 · World J Nucl Med 2020; 19(01): 28-35
DOI: 10.4103/wjnm.WJNM_15_19
Original Article

Differentiated thyroid carcinoma in children: Clinical characteristics and long-term follow-up

Muge Tamam
Department of Nuclear Medicine, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey
,
Ercan Uyanik
Department of Nuclear Medicine, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey
,
Nurcan Edís
Department of Nuclear Medicine, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey
,
Mehmet Mulazimoglu
Department of Nuclear Medicine, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey
,
Tevfik Ozpacaci
Department of Nuclear Medicine, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey
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Abstract

Differentiated thyroid cancer (DTC) is rare in children, but it still remains the most common endocrine malignancy in children. The aim of this study was to analyze treatment response to radioactive iodine (RAI) therapy, clinical outcomes, recurrences, survival analysis, and long-term follow-up. We retrospectively reviewed the medical records of 43 pediatric patients (≤17 years of age) with DTC diagnosis after thyroidectomy who were treated with RAI. The follow-up protocol consisted of detailed clinical examination, testing of thyroid function, determination of serum thyroglobulin (Tg), and anti-Tg antibodies, and neck ultrasonography application. Forty-three pediatric patients (34 females and 9 males) treated with RAI for DTC in our institute. The median follow-up period was 54 months. The histologic classification was papillary thyroid cancer in 41 patients and the remaining 2 patients had follicular thyroid cancer. After the long-term follow-up, complete remission, partial remission, and recurrent-persistent disease were observed in 37 patients, 3 patients, and 3 patients, respectively. Among the series, 1 death occurred due to multiple metastases. The mortality rate is 2.56%. Total thyroidectomy followed by RAI appears to be the most effective treatment for patients with pediatric DTC in terms of reducing the rate of relapse and improving surveillance for recurrent disease.

Keywords

Clinical outcome - long-term follow-up - pediatric differentiated thyroid carcinoma - radioactive iodine therapy - recurrence - survival analysis

Financial support and sponsorship

Nil.




Publication History

Received: 22 February 2019

Accepted: 17 May 2019

Article published online:
19 April 2022

© 2020. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Golpanian S, Perez EA, Tashiro J, Lew JI, Sola JE, Hogan AR. Pediatric papillary thyroid carcinoma: Outcomes and survival predictors in 2504 surgical patients. Pediatr Surg Int 2016;32:201-8.
  • 2 Lazar L, Lebenthal Y, Steinmetz A, Yackobovitch-Gavan M, Phillip M. Differentiated thyroid carcinoma in pediatric patients: Comparison of presentation and course between pre-pubertal children and adolescents. J Pediatr 2009;154:708-14.
  • 3 Mihailovic J, Nikoletic K, Srbovan D. Recurrent disease in juvenile differentiated thyroid carcinoma: Prognostic factors, treatments, and outcomes. J Nucl Med 2014;55:710-7.
  • 4 Kim SS, Kim SJ, Kim IJ, Kim BH, Jeon YK, Kim YK, et al. Comparison of clinical outcomes in differentiated thyroid carcinoma between children and young adult patients. Clin Nucl Med 2012;37:850-3.
  • 5 Dottorini ME, Vignati A, Mazzucchelli L, Lomuscio G, Colombo L. Differentiated thyroid carcinoma in children and adolescents: A 37-year experience in 85 patients. J Nucl Med 1997;38:669-75.
  • 6 Hay ID, Gonzalez-Losada T, Reinalda MS, Honetschlager JA, Richards ML, Thompson GB, et al. Long-term outcome in 215 children and adolescents with papillary thyroid cancer treated during 1940 through 2008. World J Surg 2010;34:1192-202.
  • 7 Vaisman F, Bulzico DA, Pessoa CH, Bordallo MA, Mendonça UB, Dias FL, et al. Prognostic factors of a good response to initial therapy in children and adolescents with differentiated thyroid cancer. Clinics (Sao Paulo) 2011;66:281-6.
  • 8 Enomoto Y, Enomoto K, Uchino S, Shibuya H, Watanabe S, Noguchi S. Clinical features, treatment, and long-term outcome of papillary thyroid cancer in children and adolescents without radiation exposure. World J Surg 2012;36:1241-6.
  • 9 Wada N, Sugino K, Mimura T, Nagahama M, Kitagawa W, Shibuya H, et al. Pediatric differentiated thyroid carcinoma in stage I: Risk factor analysis for disease free survival. BMC Cancer 2009;9:306.
  • 10 Parisi MT, Eslamy H, Mankoff D. Management of differentiated thyroid cancer in children: Focus on the American Thyroid Association pediatric guidelines. Semin Nucl Med 2016;46:147-64.
  • 11 Francis GL, Waguespack SG, Bauer AJ, Angelos P, Benvenga S, Cerutti JM, et al. Management guidelines for children with thyroid nodules and differentiated thyroid cancer. Thyroid 2015;25:716-59.
  • 12 Park S, Jeong JS, Ryu HR, Lee CR, Park JH, Kang SW, et al. Differentiated thyroid carcinoma of children and adolescents: 27-year experience in the Yonsei University health system. J Korean Med Sci 2013;28:693-9.
  • 13 Luster M, Clarke SE, Dietlein M, Lassmann M, Lind P, Oyen WJ, et al. Guidelines for radioiodine therapy of differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2008;35:1941-59.
  • 14 Bal CS, Padhy AK, Kumar A. Clinical features of differentiated thyroid carcinoma in children and adolescents from a Sub-Himalayan iodine-deficient endemic zone. Nucl Med Commun 2001;22:881-7.
  • 15 Demidchik YE, Demidchik EP, Reiners C, Biko J, Mine M, Saenko VA, et al. Comprehensive clinical assessment of 740 cases of surgically treated thyroid cancer in children of Belarus. Ann Surg 2006;243:525-32.
  • 16 Biko J, Reiners C, Kreissl MC, Verburg FA, Demidchik Y, Drozd V. Favourable course of disease after incomplete remission on (131)I therapy in children with pulmonary metastases of papillary thyroid carcinoma: 10 years follow-up. Eur J Nucl Med Mol Imaging 2011;38:651-5.
  • 17 Jarzab B, Handkiewicz-Junak D. Differentiated thyroid cancer in children and adults: Same or distinct disease? Hormones (Athens) 2007;6:200-9.
  • 18 Sakorafas GH, Giotakis J, Stafyla V. Papillary thyroid microcarcinoma: A surgical perspective. Cancer Treat Rev 2005;31:423-38.
  • 19 Zimmerman D, Hay ID, Gough IR, Goellner JR, Ryan JJ, Grant CS, et al. Papillary thyroid carcinoma in children and adults: Long-term follow-up of 1039 patients conservatively treated at one institution during three decades. Surgery 1988;104:1157-66.
  • 20 Welch Dinauer CA, Tuttle RM, Robie DK, McClellan DR, Svec RL, Adair C, et al. Clinical features associated with metastasis and recurrence of differentiated thyroid cancer in children, adolescents and young adults. Clin Endocrinol (Oxf) 1998;49:619-28.
  • 21 Rapkin L, Pashankar FD. Management of thyroid carcinoma in children and young adults. J Pediatr Hematol Oncol 2012;34 Suppl 2:S39-46.
  • 22 Wang JT, Huang R, Kuang AR. Comparison of presentation and clinical outcome between children and young adults with differentiated thyroid cancer. Asian Pac J Cancer Prev 2014;15:7271-5.
  • 23 Thompson GB, Hay ID. Current strategies for surgical management and adjuvant treatment of childhood papillary thyroid carcinoma. World J Surg 2004;28:1187-98.
  • 24 Rivkees SA, Mazzaferri EL, Verburg FA, Reiners C, Luster M, Breuer CK, et al. The treatment of differentiated thyroid cancer in children: Emphasis on surgical approach and radioactive iodine therapy. Endocr Rev 2011;32:798-826.
  • 25 Klein Hesselink MS, Nies M, Bocca G, Brouwers AH, Burgerhof JG, van Dam EW, et al. Pediatric differentiated thyroid carcinoma in the Netherlands: A nationwide follow-up study. J Clin Endocrinol Metab 2016;101:2031-9.
  • 26 Lazar L, Lebenthal Y, Segal K, Steinmetz A, Strenov Y, Cohen M, et al. Pediatric thyroid cancer: Postoperative classifications and response to initial therapy as prognostic factors. J Clin Endocrinol Metab 2016;101:1970-9.
  • 27 Samuel AM, Rajashekharrao B, Shah DH. Pulmonary metastases in children and adolescents with well-differentiated thyroid cancer. J Nucl Med 1998;39:1531-6.
  • 28 Grigsby PW, Gal-Or A, Michalski JM, Doherty GM. Childhood and adolescent thyroid carcinoma. Cancer 2002;95:724-9.
  • 29 Landau D, Vini L, A'Hern R, Harmer C. Thyroid cancer in children: The royal Marsden hospital experience. Eur J Cancer 2000;36:214-20.
  • 30 Clement SC, Kremer LC, Links TP, Mulder RL, Ronckers CM, van Eck-Smit BL, et al. Is outcome of differentiated thyroid carcinoma influenced by tumor stage at diagnosis? Cancer Treat Rev 2015;41:9-16.
  • 31 Markovina S, Grigsby PW, Schwarz JK, DeWees T, Moley JF, Siegel BA, et al. Treatment approach, surveillance, and outcome of well-differentiated thyroid cancer in childhood and adolescence. Thyroid 2014;24:1121-6.
  • 32 Hogan AR, Zhuge Y, Perez EA, Koniaris LG, Lew JI, Sola JE. Pediatric thyroid carcinoma: Incidence and outcomes in 1753 patients. J Surg Res 2009;156:167-72.