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Thyroid Cancer in Children and Adolescents

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The Thyroid and Its Diseases

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Abstract

An increasing number of children and adolescents are diagnosed with thyroid nodules. Similar to adults, the majority of nodules are benign, and the appearance of the nodule on thyroid ultrasound is the most efficient method of determining which nodules should undergo evaluation using fine needle aspiration to stratify patients for surveillance or surgical resection. Total thyroidectomy is the treatment of choice for the majority of patients with papillary thyroid cancer. Lobectomy is reserved for patients with indeterminate cytology and no evidence of a malignant oncogene, as well as differentiated thyroid cancer (DTC) variants with low invasive potential. The incorporation of the American Thyroid Association (ATA) pediatric guidelines on the evaluation and management of thyroid nodules and DTC risk levels allows for selective use of radioiodine treatment, reserving immediate postoperative RAI for patients with an increased risk of having persistent disease. For patients with a family history of multiple endocrine neoplasia type 2 (MEN2), the timing for thyroidectomy, as well as the timing for initiation of surveillance for pheochromocytoma and hyperparathyroidism, is defined by the RET codon in accordance with recommendations from ATA guidelines on medullary thyroid cancer (MTC). There is an increased risk for de novo mutations of RET codon 918 (MEN2B), and diagnosis after 4 years of age is associated with a decreased likelihood of achieving surgical remission from MTC. Disease-specific mortality for pediatric thyroid cancer is very low; however, the risk of medical and surgical complications remains high. This risk may be reduced by creation and referral of children and adolescents to regional, high-volume pediatric thyroid referral centers.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, South Korea

    Young Ah Lee

  2. Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea

    Young Ah Lee

  3. Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Andrew J. Bauer

  4. Department of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA

    Andrew J. Bauer

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  1. Young Ah Lee
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  2. Andrew J. Bauer
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Correspondence to Andrew J. Bauer .

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Editors and Affiliations

  1. Department of Nuclear Medicine, Philipps University Marburg, Marburg, Germany

    Markus Luster

  2. Unit of Endocrinology Diabetes and Metabolism, Evgenidion Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Leonidas H. Duntas

  3. Georgetown University School of Medicine, Washington, DC, USA

    Leonard Wartofsky

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Lee, Y.A., Bauer, A.J. (2019). Thyroid Cancer in Children and Adolescents. In: Luster, M., Duntas, L., Wartofsky, L. (eds) The Thyroid and Its Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-72102-6_37

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