title: Morphological and clinical presentation of papillary thyroid carcinoma in children and adolescents of Belarus: the influence of radiation exposure and the source of irradiation.
abstract: OBJECTIVE
  The aims were to analyse the features of papillary thyroid carcinoma in a large cohort of children and adolescents in Belarus and to study the influence of radiation exposure as well as the source of irradiation on the morphological and clinical presentations of tumours.
  
  
  METHODS
  The clinical and pathological features of 1086 young patients (age range=4 to 18 inclusive, followed up for ≥18years) with papillary thyroid carcinoma diagnosed during the years 1990 to 2010 were reviewed. The patients were divided into three groups: "external radiation-related", "post-Chernobyl" (internal irradiation-related) and "sporadic". Besides, patients from "post-Chernobyl" cohort (n=936) were further divided into the three equal subgroups according to the dates of surgery, which were corresponding to the early (4-9years), intermediate (10-12years) and long (14-18years) latency periods.
  
  
  RESULTS
  Patients in the "external radiation-related" group often showed extra-thyroidal extension in tumours sized ≤10mm (p=0.002). Distant metastases were more frequently (p=0.006) discovered in patients with papillary thyroid carcinoma in post-Chernobyl group (104 of 936, 11.1%) when compared to juveniles from other two groups. Lateral nodal disease and distant metastases were often noted in post-Chernobyl patients operated during the early and intermediate latency periods only.
  
  
  CONCLUSIONS
  Young patients in Belarus with papillary thyroid carcinoma in the "post-Chernobyl" group differed in many clinical and pathological parameters from those in the "sporadic" group. "External radiation related" papillary thyroid carcinomas were distinguished from other two groups of carcinoma in more advanced local spread and more aggressive behaviour of micro-carcinomas.
authors.affiliation: Republican Centre for Thyroid Tumors, Prospect Nezavisimosty 64, 220013 Minsk, Belarus; Belarusian Medical Academy of Post-Graduate Education, P. Brovki st. 3, 220013 Minsk, Belarus. Electronic address: kupriyan@rambler.ru.
authors.forename: Mikhail
authors.initials: M
authors.lastname: Fridman
authors.affiliation: School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia. Electronic address: a.lam@griffith.edu.au.
authors.forename: Alfred King-Yin
authors.initials: AK
authors.lastname: Lam
authors.affiliation: United Institute of Informatics Problems, National Academy of Sciences of Belarus, Surganova St. 6, 220012 Minsk, Belarus. Electronic address: krasko@newman.bas-net.
authors.forename: Olga
authors.initials: O
authors.lastname: Krasko
authors.affiliation: Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany. Electronic address: kw.schmid@uk-essen.de.
authors.forename: Kurt Werner
authors.initials: KW
authors.lastname: Schmid
authors.affiliation: Project Chernobyl Inc., Voorhies Av. 1810, Brooklyn, 11235 NY, USA. Electronic address: personal@doctorbranovan.com.
authors.forename: Daniel Igor
authors.initials: DI
authors.lastname: Branovan
authors.affiliation: Republican Centre for Thyroid Tumors, Prospect Nezavisimosty 64, 220013 Minsk, Belarus; Belarusian Medical Academy of Post-Graduate Education, P. Brovki st. 3, 220013 Minsk, Belarus. Electronic address: yu.demidchik@gmail.com.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Demidchik
mesh_terms: D000293:Adolescent; D002277:Carcinoma / Q000175:diagnosis* / Q000209:etiology; D002291:Carcinoma, Papillary; D016022:Case-Control Studies; D047852:Chernobyl Nuclear Accident; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D002094:Republic of Belarus; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000209:etiology
keywords: Chernobyl disaster; Children and adolescents; Papillary thyroid carcinoma