Differentiated thyroid cancer in childhood: pathology, diagnosis, therapy.
The incidence of thyroid cancer in childhood amounts to approximately 0,5/100.000/year. However, after exposure to ionizing irradiation, the incidence may increase more than 20 fold. In children, lymph node metastases of differentiated thyroid cancer are frequent (more than 50%); distant metastases mainly to the lung are seen in 20-30%. The method of choice for the primary diagnosis of thyroid cancer today is ultrasonography with 7,5 - 10 MHz probes, accompanied by fine-needle aspiration biopsy. Differentiated thyroid cancer has to be treated with a multidisciplinary approach comprising total thyroidectomy and lymph node dissection, post-operative radioiodine treatment and TSH-suppression by levothyroxine. The long-term results of this treatment approach are generally good with 10-year survival rates of 95% and higher. The treatment of children with disseminated pulmonary metastases however, may be complicated due to the increased risk of the induction of pulmonary fibrosis by radioiodine.
Reiners
Christoph
C
Clinic and Policlinic for Nuclear Medicine, University of Würzburg. reiners@nuklearmedizin.uni-wuerzburg.de
Demidchik
Yuri E
YE
D044963:Biopsy, Fine-Needle; D002648:Child; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D037981:Neck Dissection; D009367:Neoplasm Staging; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D013965:Thyroidectomy / Q000379:methods*; D014463:Ultrasonography
D007457:Iodine Radioisotopes