[Thyroid cancer in children and adolescents].
BACKGROUND
Thyroid nodules in children and adolescents may be associated to malignant neoplasms. Although thyroid cancer is a rare event in this age group, delayed diagnosis is associated to metastatic, regional or lung disease, but even in these circumstances appropriate treatment may be followed by good prognosis. We decided to review the clinical course of these patients in our hospital from 1980 to 2001.


METHODS
We found fifteen patients younger than 18 years diagnosed with thyroid carcinoma, which had been followed by at least 12 months, with a mean of 95 months and a maximal of 10 years. All patients were treated by surgery and 131 iodine, and followed by scans, ultrasound and thyroglobulin analysis.


RESULTS
The patients group were thirteen females and two males. At diagnosis, seven patients (46.7o%) had metastatic regional disease and eight had a thyroid nodule. Total thyroidectomy with a modified neck dissection and 131 iodine was the initial treatment for patients with regional disease and subtotal thyroidectomy and 131 iodine in the follow-up to treat the thyroid bed or metastases was the treatment for patients with localized disease. All patients had a histologic pattern of papillary carcinoma. Nine patients (60%) had local recurrence in a mean follow-up of 37 months, one patient that had been previously treated by total thyroidectomy and all patients that were treated by subtotal thyroidectomy, however, all responded to the complementary treatment. At this moment the mean follow up is 95 months and all the patients have survived.


CONCLUSIONS
In our experience thyroid cancer in children and adolescents is a rare event whose delayed diagnosis is associated to regional lymph node or lung metastases. Subtotal thyroidectomy was associated to disease progression to metastases, but complementary treatment was successful and all patients have survived.
Tamez-Pérez
Héctor Eloy
HE
Departamento de Endocrinologia, División de Medicina, Hospital de Especialidades No 25, IMSS, Monterrey, N.L. hectoreloytamez@aol.com
Saavedra-Castillo
Eloísa
E
Oliveros-Rodríguez
Amalia
A
Gómez-de-Ossio
María Dolores
MD
Hernández-Coria
Mayra Ivonne
MI
Tamez-Peña
Alejandra Lorena
AL
Forsbach-Sánchez
Gerardo
G
Piña-Osuna
Ana Karina
AK
Zavala-Pompa
Angel
A
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000601:surgery