ESPE Abstracts

Introduct&idot;on: Thyroid cancers are rare malignancies in childhood and their incidence is between 1.5-3% among all childhood cancers. Papillary thyroid cancer (PTC) constitutes more than 90% of childhood thyroid cancers. Risk factors for thyroid cancer include; There are iodine deficiency, radiation exposure, radiotherapy to the head and neck region, and genetic predisposition. We will present an 8-year-old case who presented with a complaint of neck swelling and was found to have papillary thyroid carcinoma as a result of the examinations.

Case: An 8-year-old female patient presented with a swelling in the neck that appeared 1 month ago. No features were found in the resume and family history. On physical examination, height: 135.6 cm (sds: 0.97); weight:30 kg (sds:0.51); body mass index: 16.3; Thyroid grade 3 palpable; S1+ S2+ rhythmic, T1 P1 detected. In the examinations of the patient, fT3: 4.65 ng/dl, fT4: 1.1 ng/dl, TSH: 3.69 mIU/L, thyroglobulin: 421 ng/dl. Thyroid USG results taken in an external center: 6x2.5x4 cm solid formation containing dense vascular multiple punctate calcifications in the right thyroid lobe, 19x14.5x23 mm in size in the inferior of the left thyroid lobe, hypoechoic suspicious spherical lymph node showing peripheral vascularization and reaching 25x12 mm in the right supraclavicular area. A peripheral suspicious pathological lymph node with moderate vascularization, whose central fatty hilum could not be discerned, was detected. Thorax CT: Nodular lesions were observed in both lungs, which may be significant in terms of multiple millimetric metastases. Thyroid FNAB pathology resulted as papillary thyroid carcinoma. Total thyroidectomy and lymph node dissection were planned by the pediatric surgeon. During the operation, thyroid right lobectomy, isthmusectomy, modified radical cervical lymph node dissection were performed due to recurrent laryngeal nerve tumor invasion. Complementary left lobectomy left modified radical cervical lymph node dissection was performed in the patient who had no signs of laryngeal nerve damage in the follow-up. Pathology report: Thyroid papillary thyroid carcinoma, diffuse sclerosing variant was detected. Radioactive iodine was planned due to distant metastasis. 100 mci RAI treatment was given by the Nuclear Medicine Department. The patient's follow-up continues with the Department of Pediatric Endocrinology, Pediatric Surgery and Nuclear Medicine.

Conclusion: Papillary thyroid carcinoma is rare in childhood. Papillary thyroid carcinoma seen in children has a more aggressive course compared to adults, and lymph node metastases, extension outside the thyroid, and lung metastases at the time of diagnosis are more common than adults.