Background: Differentiated thyroid cancer (DTC) in pediatric age might have peculiar course and prognosis.
Objective and hypotheses: To compare clinical, biochemical and ultrasound (US) features at diagnosis, histological grading and outcome in two groups of children and young adults with DTC.
Method: Clinical, biochemical and imaging characteristics of 63 patients with DTC, diagnosed between 1999 and 2014 in our hospital, were retrospectively evaluated. Patients were divided in 2 groups according to age at DTC diagnosis: group A including 18 patients aged ≤18 years (mean age 15.4±2.8); group B including 45 patients aged between 19 and 30 years (mean age 25.9±2.7). All patients underwent both surgery and radioactive iodine therapy. Follow-up period was 6.7±3.3 years for group A patients and 5.2±3.2 years for those in group B (P>0.05).
Results: 1. Tumor size (P<0.01) and metastasis rates (P<0.03) at diagnosis were higher in group A. 2. The severity of lymph node involvement, as assessed by clinical and US evaluations, was higher in group A (P=0.045). 3. Association with Hashimotos thyroiditis (HT) and thyroid dysfunction biochemical signs were more frequent in group A (P=0.045 and P=0.02 respectively). 4. Tumor recurrence rate and free survival rate were similar in the two groups.
Conclusion: DTC in children presents with a clinical and biochemical picture which differs from the one observed at presentation in young adults, due to following features: a) More frequent association with HT; b) More severe lymph node involvement; c) More frequent thyroid function biochemical alterations.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology