Endocrine Abstracts

Objective

Thyroid cancer is a rare disease in children and adolescents; it accounts for only 1.4% of all pediatric malignancies. Papillary carcinoma is the most common histological type. Furthermore, its treatment remains controversial. The aim of our work is to illustrate the clinical, histological and therapeutic features of pediatric papillary thyroid carcinoma.

Materials and methods

This is a retrospective study of 5 cases of papillary thyroid carcinoma, for which the upper age limit at the time of diagnosis was set at 15 years. This study was carried out over a period of 10 years from 2007 to 2017.

Results

The average age of our patients was 14 years, with a sex ratio of 1.5. No personal history of cervical irradiation or thyroid pathology was found. All of patients consulted for a thyroid nodule, associated with cervical lymphadenopathy in two case. A total thyroidectomy with central compartment lymph node dissection is performed in all cases. Only two patients had a lateral lymph node dissection. The diagnosis of papillary carcinoma was confirmed on the histopathological examination of the surgical specimen. The tumor was multifocal in all cases with capsular invasion and Lymph node metastases. After surgery, I-131 therapy was carried out in all patients. The evolution was favorable in all cases. No case of recurrence was noted with a mean follow-up of 4 years.

Conclusion

Compared with adults, papillary thyroid cancer in children display a greater frequency of lymph node metastases and distant metastases at the time of diagnosis and higher rates of recurrence after treatment. For this reason it should be treated differently with a long-term follow-up. The treatment is based on total thyroidectomy with lymph node dissection followed by I-131 therapy, usually giving a good prognosis.