Differentiated thyroid cancer in children: diagnosis and management.
OBJECTIVE
Differentiated thyroid cancer is the most common endocrine malignancy in children. In 2006, the American Thyroid Association Guidelines Taskforce released detailed management recommendations for differentiated thyroid cancer, which primarily addressed the approach for treating adult patients. Children with differentiated thyroid cancer present with more advanced disease and yet have a more favorable outcome than adults. Thus optimal treatment for younger patients with differentiated thyroid cancer may differ from that for adults.


RESULTS
All available data regarding differentiated thyroid cancer treatment in children are retrospective. In the past year, several large case series have been published that strengthen the argument for total thyroidectomy at the time of diagnosis, followed by administration of radioactive iodine for remnant ablation. There have also been recent advances in understanding the genetic abnormalities associated with pediatric thyroid cancer.


CONCLUSIONS
The optimal treatment of differentiated thyroid cancer in pediatric patients continues to be debated. Recent publications from institutions around the world provide useful data regarding current approaches to this unusual disease. Further collaborative studies are needed to further refine the surgical approach, particularly the extent of lymph-node dissection, radioactive iodine dosing, and the role of genetic analysis in diagnosis and clinical approach.
Yale Pediatric Thyroid Center, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520-8081, USA. catherine.dinauer@yale.edu
Catherine A
CA
Dinauer
Christopher
C
Breuer
Scott A
SA
Rivkees
D002648:Child; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008954:Models, Biological; D009367:Neoplasm Staging; D011379:Prognosis; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D013965:Thyroidectomy
D007457:Iodine Radioisotopes