title: Papillary thyroid carcinoma: demographics, treatment, and outcome in eleven pediatric patients treated at a single institution.
abstract: We describe 11 cases (8 females, 3 males) of papillary thyroid carcinoma in children treated at St. Jude Children's Research Hospital over a 33-year period, and review the literature. Ages ranged from 7-25 years (median, 16 years). Six patients had primary papillary thyroid carcinoma. Five patients had secondary papillary thyroid carcinoma after treatment of Hodgkin's disease (n = 2), acute lymphoblastic leukemia (n = 2), and neuroblastoma (n = 1) with chemotherapy and cervical radiation. The typical presentation was either cervical lymphadenopathy or a thyroid mass of short duration. Treatment consisted of thyroidectomy, cervical lymph node dissection, and postoperative thyroid hormone replacement (n = 1), parathyroid reimplantation (n = 1), 131I ablation (n = 4), external-beam irradiation (n = 1), and chemotherapy with doxorubicin (n = 1) or carboplatin and topotecan (n = 1). Nine patients are alive without evidence of disease 3.0-22.4 years from diagnosis. One patient has persistent but stable disease 17.3 years after diagnosis. One patient relapsed with metastatic lung disease 0.3 years after the initial diagnosis. He continues to do well after a brief but unsustained complete radiographic remission of disease to combination chemotherapy with carboplatin and topotecan. Our review supports excellent long-term outcome for primary or secondary papillary thyroid carcinoma in pediatric patients although complications may require close follow-up in a multidisciplinary setting.
authors.affiliation: Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA.
authors.forename: M U
authors.initials: MU
authors.lastname: Kuefer
authors.forename: M
authors.initials: M
authors.lastname: Moinuddin
authors.forename: R L
authors.initials: RL
authors.lastname: Heideman
authors.forename: R H
authors.initials: RH
authors.lastname: Lustig
authors.forename: S R
authors.initials: SR
authors.lastname: Rose
authors.forename: S
authors.initials: S
authors.lastname: Burstein
authors.forename: L
authors.initials: L
authors.lastname: VanMiddlesworth
authors.forename: I
authors.initials: I
authors.lastname: Fleming
authors.forename: J J
authors.initials: JJ
authors.lastname: Jenkins
authors.forename: P D
authors.initials: PD
authors.lastname: Shearer
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D037981:Neck Dissection; D016609:Neoplasms, Second Primary / Q000209:etiology / Q000628:therapy; D011877:Radionuclide Imaging; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D013965:Thyroidectomy; D016896:Treatment Outcome