title: Clinicopathological Characteristics of Papillary Thyroid Cancer in Children with Emphasis on Pubertal Status and Association with BRAFV600EMutation.
abstract: OBJECTIVE
  Papillary thyroid cancer (PTC) may behave differently in prepubertal children as compared to pubertal children and adults. BRAF gene activating mutations may associate with PTC by creating aberrant activation. We aimed to evaluate the clinicopathological characteristics of PTC patients with emphasis on the pubertal status and also to investigate the association of BRAFV600Emutation with disease characteristics.
  
  
  METHODS
  The medical records of 75 patients with PTC were reviewed retrospectively. BRAFV600Emutation status was available only in the medical records of 56 patients.
  
  
  RESULTS
  Mean age at diagnosis was 12.4±3.8 years. There was no difference in sex, initial signs, tumor histopathology, and pathological evidence of tumor aggressiveness between prepubertal and pubertal children. Although not statistically significant, lateral neck nodal metastasis and lung metastasis at diagnosis were more prevalent in prepubertal children. After excluding patients with microcarcinoma, prepubertal children were found to require lateral neck dissection and further doses of radioactive iodine more frequently than pubertal patients. Recurrence was also more frequent in prepubertal children (p=0.016). Frequency of BRAFV600Emutation was similar in prepubertal and pubertal patients. BRAFV600Emutation was found in 14/56 (25%) patients and was high in the classic variant PTC (p=0.004). Multicentricity was high in BRAFV600Emutation (p=0.01). There was no relation between BRAFV600Emutation and lymph node and pulmonary metastasis at diagnosis, or between BRAFV600Emutation and pathological evidence of tumor aggressiveness.
  
  
  CONCLUSIONS
  PTC is more disseminated in prepubertal children. BRAFV600Emutation does not correlate with a more extensive or aggressive disease. BRAFV600Emutation is not the cause of the differences in the biological behavior of PTC in prepubertal and pubertal children.
authors.affiliation: İstanbul University İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey.
authors.forename: Şükran
authors.initials: Ş
authors.lastname: Poyrazoğlu
authors.forename: Rüveyde
authors.initials: R
authors.lastname: Bundak
authors.forename: Firdevs
authors.initials: F
authors.lastname: Baş
authors.forename: Gülçin
authors.initials: G
authors.lastname: Yeğen
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Şanlı
authors.forename: Feyza
authors.initials: F
authors.lastname: Darendeliler
mesh_terms: D000293:Adolescent; D002291:Carcinoma, Papillary / Q000235:genetics / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009154:Mutation; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D011627:Puberty; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000235:genetics / Q000473:pathology*
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
keywords: Children; papillary thyroid cancer; pediatric thyroid cancer; puberty BRAF mutation.