Thyroid cancers in children: pathological and therapeutic specificities

Omri Malika El; Nawress Thabet; Linda Misbah; Mouna Belakhdher; Jihene Houas; Abir Meherzi; Monia Ghammam; Hamza Elfekih; Wassim Kermani; Mohamed Abdelkafi

doi:10.1530/endoabs.110.EP1452

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Endocrine Abstracts (2025) 110 EP1452 | DOI: 10.1530/endoabs.110.EP1452

ECEESPE2025 ePoster Presentations Thyroid (198 abstracts)

Thyroid cancers in children: pathological and therapeutic specificities

Malika El Omri ¹ , Nawress Thabet ² , Linda Misbah ¹ , Mouna Belakhdher ¹ , Jihene Houas ¹ , Abir Meherzi ¹ , Monia Ghammam ¹ , Hamza Elfekih ³ , Wassim Kermani ¹ & Mohamed Abdelkafi ¹

Author affiliations

¹Farhat Hached Hospital, Department of ENT and Head and Neck Surgery, Sousse, Tunisia; ²Farhat Hached University Hospital, ENT Department, Sousse, Tunisia; ³Farhat Hached Hospital, Department of Endocrinology, Sousse, Tunisia.

JOINT662

Introduction: Thyroid cancers in children are rare but often present with distinct clinical features, including higher rates of malignancy and advanced disease at diagnosis.

Objective: To analyze the clinical, paraclinical and therapeutic characteristics of pediatric thyroid cancers.

Methods: A retrospective review of children under 18 years of age who underwent surgery for thyroid nodule between January 2000 and December 2024 was conducted.

Results: Among 4920 surgeries for thyroid disease, only 29 cases (0.6%) involved children, with a mean age of 14.4 years. Most patients presented with anterior cervical swelling (82.7%), with a mean symptom duration of 11 months. Ultrasonography revealed single thyroid nodules in 58.6% and multinodular goiters in 41.4%, with malignancy suspected in 17.2%. Fine-needle aspiration cytology was performed in seven cases, confirming papillary thyroid carcinoma (PTC) in two patients. Surgical indications included compressive symptoms (51.7%), nodules >3 cm (38%), Bethesda IV cytology (6.9%), and suspected metastasis (3.4%). Total thyroidectomy (was performed in 27.6%, while hemithyroidectomy was performed in 44.8%. Lymph node dissections were performed in 27.6% of cases. Histopathological examination revealed benign lesions in 86.2% of cases, including multinodular goiters, adenomas, and lymphocytic thyroiditis. PTC was diagnosed in four patients (13.8%), with advanced disease (lung metastases) in one case. Complications occurred in 48.3% of cases, primarily transient hypoparathyroidism (41.3%). Radioactive iodine therapy was administered in PTC cases, with favorable outcomes and no recurrence reported after follow-up of 15 months.

Conclusion: Thyroid cancers in children are rare, with most lesions being benign. However, papillary thyroid carcinoma can occur, often at advanced stages. Early detection and tailored treatments, including surgery and radioactive iodine, are essential. Despite challenges, outcomes are generally favorable with multidisciplinary care.