Background: Thyroid carcinoma in childhood and adolescence is uncommon and because of the slow progression of disease the standard treatment is controversial. The aim of this study was to perform a retrospective analysis of treatment results for differentiated thyroid carcinoma in this age group treated in our clinic. Material and Methods: From August 1988 to February 2001, 15 patients between the ages of 8 and 21 years (average 16.8) were treated for differentiated thyroid carcinoma at Akdeniz University Medical School Departments of General and Pediatric Surgery. The patients included 10 (67%) females and 5 (33%) males. None of the patients had a previous positive history of head and neck irradiation. All patients, except 2, were euthyroid at the time of diagnosis. Results: Nine of the patients underwent total thyroidectomy and in 6 cases subtotal thyroidectomy was performed. There were multiple lymph node metastases in 4 (27%) patients and (various forms of) cervical lymph node dissections were performed in these patients. In addition, 2 children (13%) showed pulmonary metastasis. The incidence of surgical complications was 20% (1 permanent, 1 transient hypoparathyroidism and 1 permanent laryngeal nerve injury). Histological examinations revealed the following: papillary carcinoma in 9 (60%), follicular carcinoma in 5 (33%) patients, and Hurthle cell carcinoma in 1 (7%) patient. Postoperative radioiodine ablation was also added to treatment in 10 (67%) of the patients and all patients received L-thyroxine in suppressive doses. After a median follow-up period of 57 months (range 5–149), all patients are alive and disease-free. Conclusion: Our observations suggest that although most children and adolescents with differentiated thyroid carcinoma are seen with more extensive disease than adults, a total or subtotal thyroidectomy with an appropriate lymph node dissection followed by ablative radioiodine treatment carries a more favorable prognosis.

Liechty, RD, Safaie-Shirazi S, Soper RT: Carcinoma of the thyroid in children. Surg Gynecol Obstet 1972;134:595–599.
Schlumberger M, DeVathaire F, Travagli JP, Vassal G, Lemerle J, Parmentier C, Tubiana M: Differentiated thyroid carcinoma in childhood: Long term follow-up of 72 patients. J Clin Endocrinol Metab 1987;65:1084–1088.
Buckwalter JA, Thomas JG, Freeman JB: Is childhood thyroid cancer a lethal thyroid disease? Ann Surg 1975;181:632–638.
Withers EH, Rosenfeld L, O’Neill J, Lynch JB, Holcomb G: Long-term experience with childhood thyroid carcinoma. J Pediatr Surg 1979;14:332–335.
La Quaglia MP, Corbally MT, Heller G, Exelby PR, Brennan MF: Recurrence and morbidity in differentiated thyroid carcinoma in children. Surg 1988;104:1149–1156.
Hay ID: Papillary thyroid carcinoma. Endocrinol Metab Clin North Am 1990;19:545–576.
Zimmerman D, Hay ID, Gough IR, Goellner JR, Ryan JJ, Grant CS, McConahey WM: Papillary thyroid carcinoma in children and adults: Long-term follow-up of 1,039 patients conservatively treated at one institution during three decades. Surgery 1988;104:1157–1166.
Newman KD, Black T, Heller G, Azizkhan RG, Holcomb GW 3rd, Sklar C, Vlamis V, Haase GM, La Quaglia MP: Differentiated thyroid cancer: Determinants of disease progression in patients <21 years of age at diagnosis. Ann Surg 1998;227:553–541.
Schlumberger M, Tubiana M, De Vathaire P, et al: Long term results of treatment of 283 patients with lung and bone metastases from differentiated thyroid carcinoma. J Clin Endocrinol Metab 1986;63:960–967.
Welch Dinauer CA, Tuttle RM, Robie DK, Hill C, Gardet P, Travagli JP, Fragu P, Lumbroso J, Caillou B, Parmentier C: Extensive surgery improves recurrence-free survival for children and young patients with class I papillary thyroid carcinoma. J Pediatr Surg 1999;34:1799–1804.
Harness JK, Thompson NW, McLeod MK, Pasieka JL, Fukuuchi A: Differentiated thyroid carcinoma in children and adolescents. World J Surg 1992;16:547–554.
Farahati J, Reiners C, Stuschke M, Müller SP, Stuben G, Saverwein W, Sack H: Differentiated thyroid cancer: The impact of adjuvant external radiotherapy in patients with perithyroidal tumor infiltration (stage pT4). Cancer 1996;77:171–180.
Mazzaferri EL, Young RL: Papillary thyroid carcinoma: A 10-year follow-up report of the impact of therapy in 576 patients. Am J Med 1981;70:511–518.
Jarzab B, Handkiewicz J, Wloch J, Kalemba B, Roskosz J, Kukulska A, Puch Z: Multivariate analysis of prognostic factors for differentiated thyroid carcinoma in children. Eur J Nucl Med 2000;27:834–841.
Kerr DJ, Burt AD, Boyle P, Mac Farlane GJ, Storer AM, Brewin TB: Prognostic factors in thyroid tumors. Br J Cancer 1986;54:475–482.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.