Thyroid carcinoma in children, adolescents and adults, both spontaneous and after childhood radiation exposure

European Journal of Pediatrics
Wei Li Cindy Ho, Margaret R Zacharin

Abstract

Thyroid carcinoma is the most common second malignancy for childhood cancer survivors. Radiation exposure is linked to risk. Thyroid nodules in children have a high risk for malignancy, whether spontaneous or after radiation. Due to the extremely limited available paediatric data, we sought to review a series of patients with thyroid carcinoma, seen over 25 years. Forty-six patients were identified. Thirty-nine (84.8 %) had papillary thyroid carcinoma, five (10.9 %) follicular carcinoma and 2 (4.3 %) medullary thyroid carcinoma (MEN2B). Thirty-three (71.7 %) had childhood radiation exposure (17 females) with thyroid malignancy occurring 6-37 years later. The smallest nodule size found on surveillance to have thyroid malignancy was 4 mm. Thyroid cancer in patients 16 years and under was seen in 22 patients (47.8 %). All had total thyroidectomy, with initial central node clearance from 2005. Diagnostic rTSH stimulated I(123) scan was followed by ablative I(131) if any uptake was seen. Sixteen (32.6 %) had metastases. Twenty-four (52.2 %) had I(131), four requiring multiple courses. Forty-two remain alive and well. Ultrasound screening is required for early diagnosis as small nodule size is not predictive of benign histology or ab...Continue Reading

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Citations

Sep 7, 2018·Journal of General and Family Medicine·Kosuke OkaFumio Otsuka
May 19, 2019·Annals of Surgical Oncology·Tae Yoon LeeChan Kwon Jung
Jun 9, 2021·Annals of the Academy of Medicine, Singapore·Yee Sian TiongSamantha Peiling Yang

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