Thyroid nodules in children and adolescents: a single institution's experience

Paediatric differentiated thyroid carcinoma: a UK National Clinical Practice Consensus Guideline

This guideline is written as a reference document for clinicians presented with the challenge of managing paediatric patients with differentiated thyroid carcinoma up to the age of 19 years. Care of paediatric patients with differentiated thyroid carcinoma differs in key aspects from that of adults, and there have been several recent developments in the care pathways for this condition; this guideline has sought to identify and attend to these areas. It addresses the presentation, clinical assessment, diagnosis, management (both surgical and medical), genetic counselling, follow-up and prognosis of affected patients. The guideline development group formed of a multi-disciplinary panel of sub-speciality experts carried out a systematic primary literature review and Delphi Consensus exercise. The guideline was developed in accordance with The Appraisal of Guidelines Research and Evaluation Instrument II criteria, with input from stakeholders including charities and patient groups. Based on scientific evidence and expert opinion, 58 recommendations have been collected to produce a clear, pragmatic set of management guidelines. It is intended as an evidence base for future optimal management and to improve the quality of clinical care of paediatric patients with differentiated thyroid carcinoma.

Thyroid Surgery in Children and Adolescents: A 10-year Retrospective Study at a Single Institution

Objective

The aim of the study was to analyze clinical characteristics, surgical treatment, complications, and prognosis related to thyroid surgery in children and adolescents in a 10-year study at a single institution. Study Design. Retrospective study.

Methods

We performed a retrospective analysis of clinical data of children and adolescents who underwent thyroid surgery due to benign thyroid disease and thyroid cancer from January 2011 to May 2020. We presented the clinical characteristics and type of surgical treatment for different thyroid diseases. Results. We present data on surgical procedures and complication rates following surgery, which was comparable to other published data. We emphasize the importance of radioiodine and hormone replacement postoperative therapy in cancer patients and our opinion on total thyroidectomy and neck dissection in thyroid cancer surgery.

Conclusion

This study demonstrated that thyroid surgery in children and adolescents is a safe and efficient procedure in the hands of experienced surgeon for adult thyroid surgery. For children and adolescents with thyroid carcinoma, our method of choice is total thyroidectomy with occasionally paratracheal neck dissection, whereas lateral cervical lymph node dissection is only necessary in fine needle aspiration positive lymph nodes. Our results according to postoperative outcomes and complications are comparable to other recently published data.

Clinical characteristics and treatment of thyroid cancer in children and adolescents: a retrospective analysis of 83 patients

OBJECTIVE

To study the clinical characteristics, treatment, and prognosis of thyroid cancer in children and adolescents.

METHODS

We performed a retrospective analysis of clinical data from 83 cases of thyroid cancer in children and adolescents from January 1990 to December 2010. We compared extra-thyroid extension, lymph node metastasis, distant metastasis, and prognosis between pediatric patients ≤12 years of age (27 cases) and those >12 years of age (56 cases). All the patients agreed to undergo thyroidectomy and endocrine therapy, and the consent was obtained from parents or guardians.

RESULTS

Histopathology included papillary carcinoma in 67 cases, papillary carcinoma with partial follicular growth pattern in 1 case, papillary carcinoma with squamous metaplasia in 4 cases, follicular carcinoma in 7 cases, medullary carcinoma in 3 cases, and poorly differentiated carcinoma in 1 case. The total lymph node metastasis rate was 78.31%. Patients ≤12 years of age showed a higher rate of lymph node metastasis than the older group (92.59% vs. 71.43%, P=0.028). The incidence rate in females in the older group was higher than that in the younger group (80.36% vs. 59.26%, P=0.041). There were no significant differences in extra-thyroid extension, distant metastasis, survival rate, or recurrent disease between the two groups.

CONCLUSIONS

The lymph node metastasis of thyroid cancer is higher in patients ≤12 years of age than in those >12 years of age; the incidence rate is higher in females than in males. Childhood thyroid cancer has a good prognosis, surgery being the most effective treatment. Choosing a reasonable surgery method and comprehensive postoperative treatment can achieve a cure and satisfactory survival rate.