Papillary carcinoma of the thyroid gland in a child of thyrotoxicosis patient receiving radioactive iodine therapy: report of a case.
Herein we present the case of a 9-year-old girl who had an enlarged right lobe of the thyroid gland and sub-clinical hypothyroidism (thyroid stimulating hormone at 9.24 mIU/L). The patient had a history of unintentional exposure to radiation while her mother was receiving radionuclide therapy for diffuse toxic goiter. Ultrasonography of the young girl showed right lobe enlargement with diffuse coarse heterogenous echogenicity, compatible with a microcalcification pattern identified in both lobes of the thyroid gland. Histopathology of the tissue from a thyroidectomy revealed papillary thyroid carcinoma in the right lobe and chronic lymphocytic thyroiditis in the remaining tissue. Molecular pathology demonstrated an RET/PTC1 rearrangement in both tumor and non-tumorous tissue harboring thyroiditis. Considering the history of exposure and the characteristics of the thyroid pathology together, the PTC in this patient was likely a secondary-to-genetic alteration induced by external radiation. This case emphasizes the importance of stringent restrictions when giving radioactive iodine therapy to a patient with small children.
Sangkhathat
Surasak
S
Pediatric Surgery Unit, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand. surasak.sa@psu.ac.th
Patrapinyokul
Sakda
S
Chiengkriwate
Piyawan
P
Kritsaneepaiboon
Supika
S
Kayasut
Kanita
K
Pramphapa
Teerapol
T
Maipang
Matinee
M
D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000209:etiology*; D002648:Child; D004781:Environmental Exposure / Q000009:adverse effects*; D005192:Family Health; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use; D009035:Mothers; D009381:Neoplasms, Radiation-Induced / Q000000981:diagnostic imaging / Q000209:etiology*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013961:Thyroid Gland / Q000528:radiation effects; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology*; D013971:Thyrotoxicosis / Q000532:radiotherapy; D013997:Time Factors; D014463:Ultrasonography
D007457:Iodine Radioisotopes