THYROID-CARCINOMA IN CHILDREN AND ADOLESCENTS

Objectives: To categorize the clinical presentation of thyroid carcino ma in the pediatric and adolescent population and to present a philoso phy of surgical management based on oncologic principles. Results: Ove r half these children with thyroid carcinoma (55%) presented with an a symptomatic thyroid mass. Twelve of 26 patients presented with lymphat ic metastasis. There were no recurrences in any patient when the neck disease was treated with cervical lymphadenectomy or when the patient received post-operative radioablative therapy. Conclusions: The progno sis is excellent even with more extensive disease in children. Total t hyroidectomy along with selective neck dissection for regional metasta tic disease is recommended for thyroid carcinoma. This is followed by nuclear scintigraphy with subsequent radioablation for residual or rec urrent disease and thyroid suppression and/or replacement.