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Thyroid Cancer in Childhood and Adolescence

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Clinical Nuclear Medicine in Pediatrics

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Abstract

Thyroid cancer in children and young adolescents is a rare disease and has an excellent overall prognosis. The majority of paediatric patients have advanced disease at presentation with loco-regional lymph node involvement and are optimally managed by near/total thyroidectomy, radioiodine therapy and TSH suppression. Recurrent disease is frequent and may require additional treatment of radioiodine and possibly surgery. The main prognostic factors relating to recurrence are a younger age group, less radical surgery, no therapy with radioiodine and multifocal thyroid cancers. The application of RAI therapy has been shown to be safe with no definite side effects relating to reduced fertility and pregnancy. There appears to be a small increase in second primary malignancy (SPM), but overall, this relates not to RAI but a genetic predisposition. There is also probably an increase in SPM with the higher doses of RAI. Due to the rare occurrence of DTC in the paediatric population, there have not been any randomised trials. However due to the aggressive nature of DTC in childhood, the high recurrence rates and problems relating to life-long follow-up, the main aim in management is to minimise the risk of recurrence and the adverse side effects of surgery, radioiodine therapy, and TSH suppression. Due to the complex nature of DTC management in this age group, it is recommended that paediatric DTC be managed by a multidisciplinary team who has expertise in this area and that these patients be followed up for life requiring transition to adult care at the appropriate age.

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Author information

Authors and Affiliations

  1. Departments of Nuclear Medicine, The Children’s Hospital at Westmead, Sydney, NSW, Australia

    Robert Howman-Giles MB BS, MD, FRACP, FAANMS, DDU

  2. Disciplines of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia

    Robert Howman-Giles MB BS, MD, FRACP, FAANMS, DDU & Christopher Cowell MB, FRCP, FRACP

  3. Discipline of Medical Imaging, Sydney Medical School, University of Sydney, Sydney, NSW, Australia

    Robert Howman-Giles MB BS, MD, FRACP, FAANMS, DDU

  4. Departments of Endocrinology, Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney, NSW, Australia

    Christopher Cowell MB, FRCP, FRACP

Authors
  1. Robert Howman-Giles MB BS, MD, FRACP, FAANMS, DDU
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  2. Christopher Cowell MB, FRCP, FRACP
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Corresponding author

Correspondence to Robert Howman-Giles MB BS, MD, FRACP, FAANMS, DDU .

Editor information

Editors and Affiliations

  1. Nuclear Medicine, Second University of Naples, Napoli, Italy

    Luigi Mansi

  2. Nuclear Medicine, Humanitas Research Hospital, Rozzano, Milano, Italy

    Egesta Lopci

  3. Nuclear Medicine, Second University of Naples, Napoli, Italy

    Vincenzo Cuccurullo

  4. Nuclear Medicine, Humanitas Research Hospital, Rozzano, Milano, Italy

    Arturo Chiti

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Howman-Giles, R., Cowell, C. (2016). Thyroid Cancer in Childhood and Adolescence. In: Mansi, L., Lopci, E., Cuccurullo, V., Chiti, A. (eds) Clinical Nuclear Medicine in Pediatrics. Springer, Cham. https://doi.org/10.1007/978-3-319-21371-2_16

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  • DOI: https://doi.org/10.1007/978-3-319-21371-2_16

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-21370-5

  • Online ISBN: 978-3-319-21371-2

  • eBook Packages: MedicineMedicine (R0)

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