THYROID-CARCINOMA IN CHILDREN AND ADOLESCENTS

A clinical and pathological study was undertaken to define the prevale nce, clinical presentation and outcome of thyroid carcinoma in childre n and adolescents. Clinical records from 48 patients under 20 years of age at diagnosis, out of 372 patients with thyroid cancer examined be tween 1980 and 1994, were retrospectively reviewed. Female/male ratio was 3.8/1. None had a previous positive history of head and neck irrad iation. Patients underwent near-total (44 patients) or partial (4 pati ents) thyroidectomy followed by I-131 ablation of residual thyroid tis sue. The mean follow up period was 58.4 months, ranging between 2 and 190 months. Clinically a thyroid mass was present in 41 patients, 28 o f whom also showed neck lymph node involvement. Node metastases were p resent in 50% of the patients and lung metastases in 4.2%. Histologica l type was papillary in 41, follicular in 6, and medullary in 1 case. Surgical complications were observed in 19 patients (40%). In 3 patien ts papillary thyroid cancer was associated with chronic lymphocytic th yroiditis. All patients were treated with I-thyroxine suppressive ther apy. Recurrence of cancer after surgical and radio-iodine treatment wa s observed only in one patient 8 months after surgery. Conclusion Our experience demonstrates that thyroid carcinoma in childhood cannot be considered a rare occurrence, since it represents about 13% of all thy roid cancers, and is frequently associated with lymph node but rarely with distant metastases. Nevertheless, the prognosis of thyroid carcin oma in childhood is fairly good.