Endocrine Abstracts

JOINT2998

Introduction: Thyroid cancer is rare in childhood and adolescents representing about 0.7% of all malignant tumors in children. The incidence rate of pediatric thyroid cancer has been increasing over the last years. However, in comparison to adults, the pathophysiology, presentation, management, and long-term outcomes in children is different and not fully-known.

Aim of the work: The aim of this study is to describe clinical, laboratory, and radiological characteristics of pediatric thyroid cancer patients in a specialized tertiary-care center in Egypt. In addition, risk factors for thyroid cancer and its recurrence, treatment and outcomes were assessed.

Patients and Methods: This study was a retrospective cohort enrolling 17 children diagnosed with thyroid cancer at Alexandria Pediatric Oncology Center at age <18 years. Informed consent was obtained from parents of included children after approval of Alexandria University Ethical committee. Data was extracted from medical records of patients over a 5-year period. The following data was recorded: demographic characteristics, family history of malignancy or autoimmune thyroid disease and history of radiation exposure. Anthropometric measurements, clinical presentation, laboratory, and radiological findings, pathology results, treatment and outcomes were also reviewed.

Results: The patients’ age at diagnosis ranged between 5-17 years (mean 10.41 yrs). Almost 53% were females, while 47% were males. One patient (5.8%) was exposed to neck radiotherapy, 5 patients (29.4%) had family history of autoimmune diseases, while 3 patients (17.6%) had family history of malignancy (other than thyroid cancer). Three patients had Hashimoto’s thyroiditis with positive thyroid autoantibodies. All patients presented with neck swelling. At diagnosis, only one patient was short (-3.4 SD) and had severe hypothyroidism (TSH 106 mIU/ml), while 7 patients (41.1%) were obese. Sixteen patients (94.1%) had unilateral affection, with predilection to right side (82.3%). Fifty eight percent had nodal metastases, while 35.29% (6/17) had distant metastases including lungs. Surgery was performed in all patients; categorized into hemithyroidectomy (5.88%), total thyroidectomy (29.4%), and total thyroidectomy with nodal dissection (64.7%). The majority of patients had papillary carcinoma (94%), except one patient had follicular variant of papillary carcinoma. All patients received radioactive iodine therapy. Forty seven percent of patients developed hypoparathyroidism following surgery. As regards outcome, 4 patients (23.5%) had persistent/recurrent thyroid cancer.

Conclusion: Our study describes the outcomes of a cohort of pediatric thyroid cancer patients in a specialized center in Egypt. Children and adolescents are more likely to have more severe stages of disease with higher recurrence rate, compared to adults.