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.
Keywords
- Thyroid Cancer
- Pulmonary Metastasis
- Total Thyroidectomy
- Differentiate Thyroid Cancer
- Radioiodine Therapy
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Baudin E, Do Cao C, Cailleux AF et al (2003) Positive predictive value of serum thyroglobulin levels, measured during the first year of follow-up after thyroid hormone withdrawal, in thyroid cancer patients. J Clin Endocrinol Metab 88:1107–1111
Benua RS, Cicale NR, Sonenberg M et al (1962) The relation of radioiodine dosimetry to results and complications in the treatment of metastatic thyroid cancer. Am J Roentgenol Radium Ther Nucl Med 87:171–182
Castagna MG, Maino F, Cipri C et al (2011) Delayed risk stratification, to include the response to initial treatment (surgery and radioiodine ablation), has better outcome predictivity in differentiated thyroid cancer patients. Eur J Endocrinol 165:441–446
Cheng W, Ma C, Fu H et al (2013) Low- or high-dose radioiodine remnant ablation for differentiated thyroid carcinoma: a meta-analysis. J Clin Endocrinol Metab 98:1353–1360
Chow SM, Law SC, Mendenhall WM et al (2004) Differentiated thyroid carcinoma in childhood and adolescence-clinical course and role of radioiodine. Pediatr Blood Cancer 42:176–183
Cooper DS, Doherty GM, Haugen BR et al (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214
Cunha N, Rodrigues F, Curado F et al (2007) Thyroglobulin detection in fine-needle aspirates of cervical lymph nodes: a technique for the diagnosis of metastatic differentiated thyroid cancer. Eur J Endocrinol 157:101–107
Dinauer C, Francis GL (2007) Thyroid cancer in children. Endocrinol Metab Clin North Am 36:779–806, vii
Dinauer CA, Breuer C, Rivkees SA (2008) Differentiated thyroid cancer in children: diagnosis and management. Curr Opin Oncol 20:59–65
Dralle H, Musholt TJ, Schabram J et al (2013) German Association of Endocrine Surgeons practice guideline for the surgical management of malignant thyroid tumors. Langenbecks Arch Surg 398:347–375
Durante C, Costante G, Filetti S (2013) Differentiated thyroid carcinoma: defining new paradigms for postoperative management. Endocr Relat Cancer 20:R141–R154
Handkiewicz-Junak D, Wloch J, Roskosz J et al (2007) Total thyroidectomy and adjuvant radioiodine treatment independently decrease locoregional recurrence risk in childhood and adolescent differentiated thyroid cancer. J Nucl Med 48:879–888
Haugen BR, Sherman SI (2013) Evolving approaches to patients with advanced differentiated thyroid cancer. Endocr Rev 34:439–455
Hogan AR, Zhuge Y, Perez EA et al (2009) Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients. J Surg Res 156:167–172
Hung W, Sarlis NJ (2002) Current controversies in the management of pediatric patients with well-differentiated nonmedullary thyroid cancer: a review. Thyroid 12:683–702
Iorcansky S, Herzovich V, Qualey RR et al (2005) Serum thyrotropin (TSH) levels after recombinant human TSH injections in children and teenagers with papillary thyroid cancer. J Clin Endocrinol Metab 90:6553–6555
Ito Y, Miyauchi A, Inoue H et al (2010) An observational trial for papillary thyroid microcarcinoma in Japanese patients. World J Surg 34:28–35
Jarzab B, Handkiewicz-Junak D, Wloch J (2005) Juvenile differentiated thyroid carcinoma and the role of radioiodine in its treatment: a qualitative review. Endocr Relat Cancer 12:773–803
Jonklaas J, Sarlis NJ, Litofsky D et al (2006) Outcomes of patients with differentiated thyroid carcinoma following initial therapy. Thyroid 16:1229–1242
Lassmann M, Hanscheid H, Chiesa C et al (2008) EANM Dosimetry Committee series on standard operational procedures for pre-therapeutic dosimetry I: blood and bone marrow dosimetry in differentiated thyroid cancer therapy. Eur J Nucl Med Mol Imaging 35:1405–1412
Lima J, Trovisco V, Soares P et al (2004) BRAF mutations are not a major event in post-Chernobyl childhood thyroid carcinomas. J Clin Endocrinol Metab 89:4267–4271
Luster M, Handkiewicz-Junak D, Grossi A et al (2009) Recombinant thyrotropin use in children and adolescents with differentiated thyroid cancer: a multicenter retrospective study. J Clin Endocrinol Metab 94:3948–3953
Mazzaferri EL, Massoll N (2002) Management of papillary and follicular (differentiated) thyroid cancer: new paradigms using recombinant human thyrotropin. Endocr Relat Cancer 9:227–247
Middendorp M, Grunwald F (2010) Update on recent developments in the therapy of differentiated thyroid cancer. Semin Nucl Med 40:145–152
Mihailovic J, Nikoletic K, Srbovan D (2014) Recurrent disease in juvenile differentiated thyroid carcinoma: prognostic factors, treatments, and outcomes. J Nucl Med 55:710–717
Pacini F (2013) Management of papillary thyroid microcarcinoma: primum non nocere! J Clin Endocrinol Metab 98:1391–1393
Pacini F, Castagna MG, Brilli L et al (2012) Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol (23 Suppl 7):vii110–119
Parisi MT, Mankoff D (2007) Differentiated pediatric thyroid cancer: correlates with adult disease, controversies in treatment. Semin Nucl Med 37:340–356
Reiners C, Biko J, Haenscheid H et al (2013) Twenty-five years after Chernobyl: outcome of radioiodine treatment in children and adolescents with very high-risk radiation-induced differentiated thyroid carcinoma. J Clin Endocrinol Metab 98:3039–3048
Reiners C, Hanscheid H, Luster M et al (2011) Radioiodine for remnant ablation and therapy of metastatic disease. Nat Rev Endocrinol 7:589–595
Rivkees SA, Mazzaferri EL, Verburg FA et al (2011) The treatment of differentiated thyroid cancer in children: emphasis on surgical approach and radioactive iodine therapy. Endocr Rev 32:798–826
Rubino C, de Vathaire F, Dottorini ME et al (2003) Second primary malignancies in thyroid cancer patients. Br J Cancer 89:1638–1644
Sacks W, Braunstein GD (2014) Evolving approaches in managing radioactive iodine-refractory differentiated thyroid cancer. Endocr Pract 20:263–275
Savio R, Gosnell J, Palazzo FF et al (2005) The role of a more extensive surgical approach in the initial multimodality management of papillary thyroid cancer in children. J Pediatr Surg 40:1696–1700
Sawka AM, Thabane L, Parlea L et al (2009) Second primary malignancy risk after radioactive iodine treatment for thyroid cancer: a systematic review and meta-analysis. Thyroid 19:451–457
Schmidt M, Baum RP, Simon T et al (2010) Therapeutic nuclear medicine in pediatric malignancy. Q J Nucl Med Mol Imaging 54:411–428
Thompson GB, Hay ID (2004) Current strategies for surgical management and adjuvant treatment of childhood papillary thyroid carcinoma. World J Surg 28:1187–1198
Tuttle RM, Ball DW, Byrd D et al (2010) Thyroid carcinoma. J Natl Compr Canc Netw 8:1228–1274
Tuttle RM, Tala H, Shah J et al (2010) Estimating risk of recurrence in differentiated thyroid cancer after total thyroidectomy and radioactive iodine remnant ablation: using response to therapy variables to modify the initial risk estimates predicted by the new American Thyroid Association staging system. Thyroid 20:1341–1349
Verburg FA, Biko J, Diessl S et al (2011) I-131 activities as high as safely administrable (AHASA) for the treatment of children and adolescents with advanced differentiated thyroid cancer. J Clin Endocrinol Metab 96:E1268–E1271
Wells SA Jr, Santoro M (2014) Update: the status of clinical trials with kinase inhibitors in thyroid cancer. J Clin Endocrinol Metab 99:1543–1555
Fancis GL, Waguespack SG, Bauer AJ et al (2015) Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 25(7):716–759
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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
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