PAPILLARY THYROID-CARCINOMA - DEMOGRAPHICS, TREATMENT, AND OUTCOME IN11 PEDIATRIC-PATIENTS TREATED AT A SINGLE INSTITUTION

We describe 11 cases (8 females, 3 males) of papillary thyroid carcino ma in children treated at St. Jude Children's Research Hospital over a 33-year period, and review the literature. Ages ranged from 7-25 year s (median, 16 years). Six patients had primary papillary thyroid carci noma. Five patients had secondary papillary thyroid carcinoma after tr eatment of Hodgkin's disease (n = 2), acute lymphoblastic leukemia (n = 2), and neuroblastoma (n = 1) with chemotherapy and cervical radiati on. The typical presentation was either cervical lymphadenopathy or a thyroid mass of short duration. Treatment consisted of thyroidectomy, cervical lymph node dissection, and postoperative thyroid hormone repl acement (n = 11), parathyroid reimplantation (n = 1), I-131 ablation ( n = 4), external-beam irradiation (n = 1), and chemotherapy with doxor ubicin (n = 1) or carboplatin and topotecan (n = 1). Nine patients are alive without evidence of disease 3.0-22.4 years from diagnosis. One patient has persistent but stable disease 17.3 years after diagnosis. One patient relapsed with metastatic lung disease 0.8 years after the initial diagnosis. He continues to do well after a brief but unsustain ed complete radiographic remission of disease to combination chemother apy with carboplatin and topotecan. Our review supports excellent long -term outcome for primary or secondary papillary thyroid carcinoma in pediatric patients, although complications may require close follow-up in a multidisciplinary setting. (C) 1997 Wiley-Liss, Inc.