title: Differentiated thyroid carcinoma in children and adolescents. Clinical characteristics, treatment and outcome of 15 patients.
abstract: BACKGROUND
  Thyroid carcinoma in childhood and adolescence is uncommon and because of the slow progression of disease the standard treatment is controversial. The aim of this study was to perform a retrospective analysis of treatment results for differentiated thyroid carcinoma in this age group treated in our clinic.
  
  
  METHODS
  From August 1988 to February 2001, 15 patients between the ages of 8 and 21 years (average 16.8) were treated for differentiated thyroid carcinoma at Akdeniz University Medical School Departments of General and Pediatric Surgery. The patients included 10 (67%) females and 5 (33%) males. None of the patients had a previous positive history of head and neck irradiation. All patients, except 2, were euthyroid at the time of diagnosis.
  
  
  RESULTS
  Nine of the patients underwent total thyroidectomy and in 6 cases subtotal thyroidectomy was performed. There were multiple lymph node metastases in 4 (27%) patients and (various forms of) cervical lymph node dissections were performed in these patients. In addition, 2 children (13%) showed pulmonary metastasis. The incidence of surgical complications was 20% (1 permanent, 1 transient hypoparathyroidism and 1 permanent laryngeal nerve injury). Histological examinations revealed the following: papillary carcinoma in 9 (60%), follicular carcinoma in 5 (33%) patients, and Hurthle cell carcinoma in 1 (7%) patient. Postoperative radioiodine ablation was also added to treatment in 10 (67%) of the patients and all patients received L-thyroxine in suppressive doses. After a median follow-up period of 57 months (range 5-149), all patients are alive and disease-free. CONCLUSUION: Our observations suggest that although most children and adolescents with differentiated thyroid carcinoma are seen with more extensive disease than adults, a total or subtotal thyroidectomy with an appropriate lymph node dissection followed by ablative radioiodine treatment carries a more favorable prognosis.
authors.affiliation: Department of General Surgery, Akdeniz University Medical Faculty, Antalya, Turkey.
authors.forename: Cumhur
authors.initials: C
authors.lastname: Arici
authors.forename: Okan
authors.initials: O
authors.lastname: Erdogan
authors.forename: Hasan
authors.initials: H
authors.lastname: Altunbas
authors.forename: Adil
authors.initials: A
authors.lastname: Boz
authors.forename: Mustafa
authors.initials: M
authors.lastname: Melikoglu
authors.forename: Binnur
authors.initials: B
authors.lastname: Karayalcin
authors.forename: Tuncer
authors.initials: T
authors.lastname: Karpuzoglu
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018249:Adenoma, Oxyphilic / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D000293:Adolescent; D000328:Adult; D002291:Carcinoma, Papillary / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006044:Goiter, Nodular / Q000175:diagnosis; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D013965:Thyroidectomy; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D007457:Iodine Radioisotopes; D013974:Thyroxine