title: Differentiated thyroid carcinoma: presentation and follow-up in children and adolescents.
abstract: To review our Pediatric Endocrinology Division's experience with differentiated thyroid carcinoma (DTC) we analyzed retrospectively the records of patients with DTC that had been seen between June 1988 and June 2008.
  
  
  RESULTS
  Forty-five patients (median age 13.7 years, 36 female) were diagnosed (papillary: 40, follicular: 5) with DTC presenting as a solitary nodule (n: 25), thyroid nodule with cervical adenopathy (n: 9) and multinodular goiter (n: 11). All underwent total thyroidectomy with resection of suspicious cervical lymph nodes (CLN). DTC was multicentric in 59% and revealed extrathyroidal extension in 44%. Initially, 44% had CLN metastases and 24% distant metastases. All patients underwent thyroid remnant ablation with 131I and suppressive treatment. Median follow-up was 5.1 years with a disease-free survival rate at 5 years of follow-up of 75%. Eleven percent presented recurrences.
  
  
  CONCLUSIONS
  Pediatric DTC has an aggressive behavior at presentation. Higher preoperative TSH levels were significantly associated with a more advanced disease at diagnosis. CLT was present concomitantly in a quarter of the patients and further studies are needed to establish differences in these patients' outcome. Diagnostic approach, total thyroidectomy, 131I treatment and thyrotropin suppression allowed a good progression-free survival rate.
authors.affiliation: Endocrinology Division, Centro de Investigaciones Endocrinológicas (CEDIE), Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina. patopapen@yahoo.com.ar
authors.forename: Patricia
authors.initials: P
authors.lastname: Papendieck
authors.forename: Laura
authors.initials: L
authors.lastname: Gruñeiro-Papendieck
authors.forename: Marcela
authors.initials: M
authors.lastname: Venara
authors.forename: Oscar
authors.initials: O
authors.lastname: Acha
authors.forename: Silvana
authors.initials: S
authors.lastname: Maglio
authors.forename: Ignacio
authors.initials: I
authors.lastname: Bergadá
authors.forename: Ana
authors.initials: A
authors.lastname: Chiesa
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D000293:Adolescent; D002291:Carcinoma, Papillary / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D002454:Cell Differentiation; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes