Introduction: Thyroid cancer is the most common pediatric endocrine cancer, constituting 0.5%3% of all childhood malignancies. Cancer can be present in multinodular thyroid disease but the majority of malignant nodules are solitary. Thyroid malignancies in children are almost always well differentiated.
Aim: Prevalence, clinical features, pathological profile and therapy of thyroid cancer in children.
Patients and method: Retrospective study of patients admitted with diagnosis of nodular goiter in the Endocrinology Department, St. Spiridon Hospital, Iasi, Romania, between 2011 and 2018. Demographic data (sex/age), clinical examination, thyroid ultrasonographic features, hormonal profile, treatment (surgery or active surveillance) as well as histological aspects were recorded.
Results: In a period of 7 years 35 children (26 girls and nine boys) were admitted for nodular goiter. Age stratification showed 6 (17, 1%) patients aged 12, 7 (20%) patients aged 15 and 8 (22%) patients aged 16. Only 20 patients presented clinical evident nodular goiter and in 15 patients the thyroid ultrasound revealed nodular lesions in one or both lobes. According to the ultrasound structure has been found: two patients with solitary micro nodule (< 1 cm) in the right thyroid lobe, three patients solitary micro nodule in the left thyroid lobe, 3 patients with polymicronodular aspect, 8 patients with solitary macro nodule (>1 cm) in the right thyroid lobe, 8 patients with solitary macro nodule in the left thyroid lobe, three patients with multiple macro nodules in both lobes, 1 patient with cystic lesion (>1 cm), four patients with micro cystic lesion, two patients with nodular Hashimoto thyroiditis and one patient with micro nodules in Graves Basedow disease. Surgery was performed in 16 cases (45.6%) with the following results: follicular adenomas 6 cases, Graves disease + follicular adenoma 1 case, toxic adenoma 1 case, follicular carcinoma 1 case, Graves disease + papillary carcinoma 1 case, papillary carcinoma 4 cases, medullary carcinoma (MEN 2a) 1 case and well differentiated tumor of uncertain malignant potential 1 case. The total number of patients with thyroid carcinoma was 8 with a prevalence of 20%.
Conclusions: Nodular goiter is more frequent at the age of 12, 15 and 16. The prevalence of thyroid cancer is quite high (20%) with predominance of papillary carcinoma. The clinical examination and thyroid ultrasound are mandatory in diagnostic algorithm of thyroid carcinoma.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology