Skip to main content

Advertisement

Log in

Differentiated thyroid carcinoma: comparison of histopathologic characteristics, clinical course, and outcome between young children and adolescents

  • Original Paper
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

Differentiated thyroid carcinoma is rare in patients younger than 21 years, especially in children, but it is associated with a greater risk of metastases and recurrence. The aim of our study was to compare the characteristics, clinical course, and outcome of the disease between young children (≤16 years) and adolescents (17–21 years). We reviewed the medical records of 62 young children and adolescents (47 females, 15 males, ≤21 years) with DTC who were diagnosed between 1990 and 2010 and admitted for radioiodine therapy, and compared the histopathologic features, amount and session(s) of radioiodine administration, and outcome in both groups. Young children presented with larger tumor size, more aggressive pathological features, higher incidence of locoregional and distant metastasis, and needed more admissions, and higher amounts of radioiodine for treatment. While there were more disease-free patients at the end of follow-up in the adolescents, the number of patients with stable or progressive disease was higher in younger group. Based on the results of our study, we support the more aggressive approach to DTC treatment in young children, including total thyroidectomy along with more extensive cervical lymph node dissection, L-T4 therapy in suppressive doses, and multiple sessions of postsurgical radioiodine therapy as necessitated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Buckwalter JA, Gurll NJ, Thomas CG. Cancer of the thyroid in youth. World J Surg. 1981;5:15–25.

    Article  PubMed  CAS  Google Scholar 

  2. Samuel AM, Sharma SM. Differentiated thyroid carcinomas in children and adolescents. Cancer. 1991;67:2186–90.

    Article  PubMed  CAS  Google Scholar 

  3. Clark RM, Rosen IB, Laperierre NJ. Malignant tumors of the head and neck in a young population. Am J Surg. 1982;144:459–62.

    Article  PubMed  CAS  Google Scholar 

  4. Hogan AR, Zhuge Y, Perez EA, Koniaris LG, Lew JI, et al. Pediatric thyroid carcinoma: incidence and outcomes in 1,753 patients. J Surg Res. 2009;156:167–72.

    Article  PubMed  Google Scholar 

  5. Farahati J, Bucsky P, Parlowsky T, Mader U, Reiners C. Characteristics of differentiated thyroid carcinoma in children and adolescents with respect to age, gender, and histology. Cancer. 1997;80:2156–62.

    Article  PubMed  CAS  Google Scholar 

  6. Robie DK, Dinauer CW, Tuttle RM, Ward DT, Parry R, McClellan D, Svec R, Adair C, Francis G. The impact of initial surgical management on outcome in young patients with differentiated thyroid cancer. J Pediatr Surg. 1998;33:1134–8.

    Article  PubMed  CAS  Google Scholar 

  7. Hogan AR, Zhuge Y, Perez EA, Koniaris LG, Lew JI, et al. Pediatric thyroid carcinoma: incidence and outcomes in 1,753 patients. J Surg Res. 2009;156:167–72.

    Article  PubMed  Google Scholar 

  8. Luster M, Lassmann M, Freudenberg LS, Reiners C. Thyroid cancer in childhood: management strategy, including dosimetry and long-term results. Hormones (Athens). 2007;6:269–78.

    Google Scholar 

  9. Thompson GB, Hay ID. Current strategies for surgical management and adjuvant treatment of childhood papillary thyroid carcinoma. World J Surg. 2004;28:1187–98.

    Article  PubMed  Google Scholar 

  10. Welch Dinauer CA, Tuttle RM, Robie DK. Clinical features associated with metastasis and recurrence of differentiated thyroid cancer in children, adolescent and young adults. Clin Endocrinol (Oxf). 1998;49:619–28.

    Article  CAS  Google Scholar 

  11. Hay ID, Gonzalez-Losada T, Reinalda MS, Honetschlager JA, Richards ML, et al. Longterm outcome in 215 children and adolescents with papillary thyroid cancer treated during 1940 through 2008. World J Surg. 2010;34:1192–202.

    Article  PubMed  Google Scholar 

  12. O’Gorman CS, Hamilton J, Rachmiel M, Gupta A, Ngan BY, et al. Thyroid cancer in childhood: a retrospective review of childhood course. Thyroid. 2010;20:375–80.

    Article  PubMed  Google Scholar 

  13. Silva F, Laguna R, Nieves-Rivera F. Pediatric thyroid cancer with extensive disease in a Hispanic population: outcome and long-term survival. J Pediatr Endocr Met. 2010;23:59–64.

    Google Scholar 

  14. Waguespack SG, Francis G. Initial management and follow-up of differentiated thyroid cancer in children. J Natl Compr Canc Netw. 2010;8:1289–300.

    PubMed  Google Scholar 

  15. Verburg FA, Mader U, Luster M, Reiners C. Histology does not influence prognosis in differentiated thyroid carcinoma when accounting for age tumour diameter, invasive growth and metastases. Eur J Endocrinol. 2009;160:619–24.

    Article  PubMed  CAS  Google Scholar 

  16. Landau D, Vini L, A’Hern R, Harmer C. Thyroid cancer in children: the royal Marsden hospital experience. Eur J Cancer. 2000;36:214–20.

    Article  PubMed  CAS  Google Scholar 

  17. Zimmerman D, Hay ID, Gough IR, Goellner JR, Ryan JJ, et al. Papillary thyroid carcinoma in children and adults: long-term follow-up of 1,039 patients conservatively treated at one institution during three decades. Surgery. 1988;104:1157–66.

    PubMed  CAS  Google Scholar 

  18. Reiners C, Demidchik YE, Drozd VM, Biko J. Thyroid cancer in infants and adolescents after Chernobyl. Minerva Endocrinol. 2008;33:381–95.

    PubMed  CAS  Google Scholar 

  19. Biko J, Reiners C, Kreissl MC, Verburg FA, Demidchik Y, et al. Favourable course of disease after incomplete remission on (131) I therapy in children with pulmonary metastases of papillary thyroid carcinoma: 10 years follow-up. Eur J Nucl Med Mol Imaging. 2011;38:651–5.

    Article  PubMed  Google Scholar 

  20. Jarzab B, Handkiewicz-Junak D, Wloch J. Juvenile differentiated thyroid carcinoma and the role of radioiodine in its treatment: a qualitative review. Endocr-Relat Cancer. 2005;12:773–803.

    Article  PubMed  CAS  Google Scholar 

  21. Rybakov SJ, Komissarenko IV, Tronko ND, e Kvachenyuk AN, Bogdanova TI, Kovalenko AE, Bolgov MY. Thyroid cancer in children of Ukraine after the Chernobyl accident. World J Surg. 2000;24:1446–9.

    Article  PubMed  CAS  Google Scholar 

  22. Ceccarelli C, Pacini F, Lippi F, Elisei R, Arganini M, et al. Thyroid cancer in children and adolescents. Surgery. 1988;104:1143–8.

    PubMed  CAS  Google Scholar 

  23. Dottorini ME, Vignati A, Mazzucchelli L, Lomuscio G, Colombo L. Differentiated thyroid carcinoma in children and adolescents: a 37-year experience in 85 patients. J Nucl Med. 1997;38:669–75.

    PubMed  CAS  Google Scholar 

  24. Zimmermann D, Hay ID, Gough IR, et al. Papillary thyroid cancer in children and adults: long-term follow-up of 1,039 patients conservatively treated at one institution during three decades. Surgery. 1988;104:1157–66.

    Google Scholar 

  25. La Quaglia MP, Corbally MT, Heller G, et al. Recurrence and morbidity in differentiated thyroid carcinoma in children. Surgery. 1988;104:1149–56.

    PubMed  Google Scholar 

  26. Harness JK, Thompson NW, McLeod MK, et al. Differentiated thyroid carcinoma in children and adolescents. World J Surg. 1992;16:547–54.

    Article  PubMed  CAS  Google Scholar 

  27. Segal K, Shvero J, Stern Y, et al. Surgery of thyroid cancer in children and adolescents. Head Neck. 1998;20:293–7.

    Article  PubMed  CAS  Google Scholar 

  28. Hod N, Hagag P, Baumer M, Sandbank J, Horne T. Differentiated thyroid carcinoma in children and young adults: evaluation of response to treatment. Clin Nucl Med. 2005;30:387–90.

    Article  PubMed  Google Scholar 

  29. Newman KD, Black T, Heller G, et al. Differentiated thyroid cancer: determinants of disease progression in patients <21 years of age at diagnosis: a report from the Surgical Discipline Committee of the Children’s Cancer Group. Ann Surg. 1998;227:533–41.

    Article  PubMed  CAS  Google Scholar 

  30. Jarzab B, Handkiewicz Junak D, Wloch J, et al. Multivariate analysis of prognostic factors for differentiated thyroid carcinoma in children. Eur J Nucl Med. 2000;27:833–41.

    Article  PubMed  CAS  Google Scholar 

  31. Chow SM, Law SC, Mendenhall WM, Au SK, Yau S, Mang O, Lau WH. Differentiated thyroid carcinoma in childhood and adolescence-clinical course and role of radioiodine. Pediatr Blood Cancer. 2004;42:176–83.

    Article  PubMed  Google Scholar 

  32. Handkiewicz-Junak D, Wloch J, Roskosz J, et al. Total thyroidectomy and adjuvant radioiodine treatment independently decrease loco regional recurrence risk in childhood and adolescent differentiated thyroid cancer. J Nucl Med. 2007;48:879–88.

    Article  PubMed  CAS  Google Scholar 

  33. Enomoto Y, Enomoto K, Uchino S, et al. Clinical features, treatment, and long-term outcome of papillary thyroid cancer in children and adolescents without radiation exposure. World J Surg. 2012;36(6):1241–6.

    Article  PubMed  Google Scholar 

  34. Grigsby PW, Gal-or A, Michalski JM, Doherty GM. Childhood and adolescent thyroid carcinoma. Cancer. 2002;95:724–9.

    Article  PubMed  Google Scholar 

  35. Dzepina D. Surgical and pathological characteristics of papillary thyroid cancer in children and adolescents. Int J Pediatr. 2012;2012:125389.

    PubMed  Google Scholar 

  36. Lin JD, Chao TC, Hsueh C, Kuo SF. High recurrent rate of multicentric papillary thyroid carcinoma. Ann Surg Oncol. 2009;16(9):2609–16.

    Article  PubMed  Google Scholar 

  37. Sherman SI. Thyroid carcinoma. Lancet. 2007;361:501–11.

    Article  Google Scholar 

  38. Mazzaferri EL, Massoll N. Management of papillary and follicular (differentiated) thyroid cancer: new paradigms using recombinant human thyrotropin. Endocr Relat Cancer. 2002;9:227–47.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Motazedian.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Motazedian, M., Shafiei, B., Vatankhah, P. et al. Differentiated thyroid carcinoma: comparison of histopathologic characteristics, clinical course, and outcome between young children and adolescents. Med Oncol 30, 506 (2013). https://doi.org/10.1007/s12032-013-0506-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-013-0506-y

Keywords

Navigation