The association of thyroid carcinoma with Graves' disease is considered rare and remains exceptional because it accounts for only 1-2% of childhood cancers.
We report an observation of a 10-year-old girl from a goitrous endemic area (CHLEF) with exophthalmia. It shows signs of obvious thyrotoxicosis with with a very firm, homogeneous and asymmetrical goiter on the right.. A hormonal assessment, an echography and a thyroid scintigraphy confirm the diagnosis of Graves' disease. The patient is treated with ATS for 4 years and then operated on by total thyroidectomy. The patient was then placed on levothyrox and a follow-up ultrasound as well as the operative and anapathological report were requested.
Ultrasound refers to an empty thyroid compartment and no ADP or thyroid abnormality. The anatomo-pathological study shows a well-differentiated vesicular carcinoma of the thyroid and the surgical protocol reports only the concept of total thyroidectomy without lymph node dissection. We decide to do an iratherapy and then to prescribe to the patient a frenator treatment based on levothrox. The follow-up is ensured at our level since already 5 years without any other complication.
Our observation reinforces the literature series on the frequency of the association of Graves' disease and thyroid carcinoma in children and stresses the message that hyperthyroidism is not a guarantee against thyroid cancer.
Keywords: Graves' disease - Thyroid carcinoma- Child.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology