title: Tall cell variant of papillary thyroid carcinoma in children: report of three cases with long-term follow-up from a single institution.
abstract: Papillary thyroid carcinoma (PTC), tall cell (TC) variant, is exceptional in children. In adults it represents about 20% of PTCs, featuring a high-risk neoplasm, with a 4-fold risk of relapse and a 20-fold relapse-related risk of death. Out of 42 cases of pediatric PTCs, we found 3 cases of PTC-TC (7%) with clinical data at onset and follow-up up to June 2014. They were 3 females aged 13, 15, and 15 years. Local extrathyroid extension was present in 2 cases. Neither nodal nor distant metastases were found. Two patients underwent hemithyroidectomy and 1 patient a total thyroidectomy, followed in all cases by life-long suppressive hormonal therapy. On follow-up, the patients were alive and well after 29, 24, and 29 years, respectively. The rarity of PTC-TC in children was confirmed. The behavior was indolent after a median follow-up of about 29 years, following treatment with hemithyroidectomy in 2 cases and controlled by suppressive hormonal therapy. The results of this series, albeit small, suggest that TC morphology in PTC does not carry the same negative prognostic significance in children as it does in adults. A conservative approach should therefore be considered for these 'pediatric type' cases of this tumor type.
authors.affiliation: IRCCS Istituto Nazionale dei Tumori, Milan, Italy Department of Diagnostic Pathology and Laboratory Medicine, IRCCS Istituto Nazionale dei Tumori, Milan, Italy paola.collini@istitutotumori.mi.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Collini
authors.affiliation: IRCCS Istituto Nazionale dei Tumori, Milan, Italy Unit of Paediatrics, IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Massimino
authors.affiliation: IRCCS Istituto Nazionale dei Tumori, Milan, Italy Unit of Thyroid Pathology Surgery, IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Mattavelli
authors.affiliation: IRCCS Istituto Nazionale dei Tumori, Milan, Italy Department of Diagnostic Pathology and Laboratory Medicine, IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Barisella
authors.affiliation: IRCCS Istituto Nazionale dei Tumori, Milan, Italy Unit of Paediatrics, IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Podda
authors.affiliation: Centro Diagnostico Italiano, Milan, Italy.
authors.forename: Juan
authors.initials: J
authors.lastname: Rosai
mesh_terms: D000293:Adolescent; D002277:Carcinoma / Q000473:pathology* / Q000628:therapy; D002291:Carcinoma, Papillary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000628:therapy; D013965:Thyroidectomy
keywords: age; childhood; pediatric type; prognosis; tall cell papillary carcinoma; therapy; thyroid carcinoma