Childhood thyroid cancer. Characteristics and long-term outcome in children irradiated for benign conditions of the head and neck.
OBJECTIVE
To determine the characteristics and long-term outcome of radiation-induced thyroid cancer in children.


METHODS
Retrospective review of a cohort of 4296 irradiated patients who received childhood radiation treatment to the head and neck area at the same hospital.


METHODS
Forty-one children who were younger than 20 years when thyroid cancer developed in them and 77 adults in whom thyroid cancer developed. All 118 cases were diagnosed before 1974 and were followed up for a median of 19.4 years.


RESULTS
Children presented with clinically palpable lymph nodes more often than adults (30.7% vs 15.1%, P = .05) and had more recurrences (39% vs 16%, P = .05). Despite these frequent recurrences, only one patient (an adult) died of thyroid cancer. Seventy percent of the recurrences occurred during the first 10 years of follow-up, but recurrences continued after 20 years. The adults had previously identified factors that predicted the risk of recurrences, but none could be identified in the children.


CONCLUSIONS
The presentation and relatively good outcome of radiation-induced thyroid cancer in children is similar to that in nonirradiated children. Frequent and late recurrences call for lifelong follow-up.
Viswanathan
K
K
Section of Endocrinology and Metabolism, University of Illinois College of Medicine, Michael Reese Hospital, Chicago.
Gierlowski
T C
TC
Schneider
A B
AB
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000209:etiology / Q000556:secondary / Q000601:surgery; D018265:Carcinoma, Papillary, Follicular / Q000175:diagnosis / Q000209:etiology / Q000556:secondary / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006257:Head / Q000528:radiation effects; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009333:Neck / Q000528:radiation effects; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000628:therapy; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome