Thyroid Carcinoma In Children Research Articles

Papillary carcinoma of the thyroid gland and atresia of the common bile ducts of a five year old boy

We present a case of papillary carcinoma of the thyroid gland with pulmonary metastases in a 5 year old boy. The child also suffered from atresia of the gallbladder and the common bile ducts with biliary cirrhosis of the liver and died from hepatic insufficiency. Possible correlations between childhood thyroid carcinoma and congenital malformations are discussed.

The syndrome of multiple aucosal neuromas and medullary thyroid carcinoma in childhood. Importance of recognition of the phenotype for the early detection of malignancy.

Recognition of the syndrome of OF MMN can identify individuals at risk for the early appearance of MTC. Three such patients are described. Each had the characteristic neuromas and facies, present since infancy. In each, MTC was found in childhood. In the last two patients, the diagnosis was made because of elevated serum CT concentrations. Venous drainage from the tumor, as well as tumor tissue itself, contained high levels of CT. Prompt recognition of persons with MMN is essential for proper investigation and treatment of the associated MTC.

IS THE INCIDENCE OF CHILDHOOD THYROID CARCINOMA DECLINING?

In the last 15 years 32 children aged 6 to 19 have been referred to Massachusetts Gen. Hosp. with solitary thyroid nodules. Excisional biopsy revealed carcinoma in 5 (15%), adenoma in 18 (56%), and miscellaneous diagnoses in 9 (28%). Patients with carcinoma, ages 7-15, gave no history of x-ray exposure in infancy, and all were euthyroid. Lymph node metastases were present in all at the time of diagnosis. Treatment included thyroidectomy, modified radical node dissection, and mediastinal explorations, and postoperative full replacement thyroid therapy. Two patients were treated with I131 additionally. One of these died of lung metastases; the other was lost to follow-up. The remainder, followed for 4-8 years, were disease free when last seen. Benign thyroid tumors were present in 4 boys and 14 girls, ages 6 to 19, with a mean age of 14. All were euthyroid; 8/18 had technetium scans showing 6 “warm” and 2 “cold” nodules. At surgery there were 15 follicular adenomas, 2 fetal adenomas, and a Hurthle cell adenoma. Miscellaneous conditions seen in the remaining patients included ectopic normal thyroid tissue and agenesis of the left thyroid lobe. In the past, 50% of nodules in childhood were malignant (1). Our series, born since knowledge of the danger of irradiation induced malignancies became widespread, suggests the incidence of childhood thyroid carcinoma may be declining. (1) Hayles, A. B., et al., Amer. J. Surg. 106: 735, 1963.

Childhood thyroid carcinoma: Jay K. Harness, Norman W. Thompson, and Ronald H. Nishiyama. Arch. Surg. 102: 278–284 (April), 1971

Childhood thyroid carcinoma: Jay K. Harness, Norman W. Thompson, and Ronald H. Nishiyama. Arch. Surg. 102: 278–284 (April), 1971

Thyroid carcinoma in children: a selective operative approach.

Thyroid carcinoma in children: a selective operative approach.

Childhood thyroid carcinoma.

Twenty-nine (50%) of 58 children with thyroid carcinoma received previous ionizing radiation to the head and neck. The average interval to diagnosis was 9.6 years. Fifty-six carcinomas were either papillary, follicular, or mixed differentiated tumors. Two carcinomas were medullary with amyloid struma. There were no undifferentiated carcinomas. Cervical lymphatic metastases were present in 88%. Local infiltration of tumor occurred in 31% and pulmonary metastases in 19%. Fifty-one patients (88%) have undergone total thyroidectomy. Forty-eight patients underwent lymph node excisions ranging from lymph node plucking to bilateral modified and radical neck dissections. Sodium iodide I 131 was administered in therapeutic doses to 49 of the 58 patients in our series. The thyroid carcinoma mortality was 5.2%. There were no deaths in those patients who underwent total thyroidectomy and appropriate regional lymph node dissection, and received therapeutic sodium iodide I 131 when indicated on the basis of follow-up scans.

90. Thyroid carcinoma in infancy and childhood (III)

90. Thyroid carcinoma in infancy and childhood (III)

140 小児甲状腺癌について (頸胸部)

140 小児甲状腺癌について (頸胸部)

Thyroid Carcinoma in Children

Thyroid Carcinoma in Children

Thyroid carcinoma in children. A plea for conservation of functions.

Within the last 20 years there has been a definite increase in the incidence of thyroid carcinoma. 8,12,15 Both an absolute increase in numbers of cases and a relative increase in comparison with other forms of thyroid disease have been observed. Better diagnostic techniques and their wider usage have undoubtedly contributed to this increase. Some authors believe that we are now discovering the long-term consequences of using radiation to the neck of young children. 3,6,14,15 It is also possible that more children with abnormalities of the branchial cleft derivatives are now surviving to adolescence, where the growth disturbances become apparent as neoplasms. Simultaneously, the relative importance of cancer as a cause of death in children has increased. The discovery and wide use of powerful antimicrobial agents has reduced deaths from respiratory diseases to their present third position. Cancer has now become the second commonest cause of death in childhood, exceeded

6 cases of thyroid carcinoma in childhood

Out of 302 cases of thyroid carcinoma seen at the Cancer Institute of Milan, six occurred in children, 5 females and 1 male. Two were papillary carcinomas. In three cases the first clinical symptom was a lymph node metastasis. In 5 cases combined surgical and radiological therapy was instituted, and in 1 case radiological therapy alone was applied. The patients are alive and well after a period ranging between 1 month and 15 years. A survey of a total of 12 cases of childhood thyroid carcinoma published in the Italian literature revealed in 3 cases a history of x-rays treatment at variable time before the onset of the thyroid tumor.

A study of thyroid cancer in children

Children (286) with thyroid cancer were studied. Of these, 80% had received therapeutic radiation to the head or neck at some time during infancy or childhood. Most of the patients were treated for so-called enlarged thymus gland; others for hypertrophied tonsils and adenoids, hemangiomas, nevi, acne, eczema, and other benign diseases, The dosage administered varied from 180 to 6000, with an average of 600 r, but accurate data of radiation dosage were obtained for oniy 200 cases. The average interval between irradiation and discovery of carcinoma was 8.8 years. A history of previous irradiation in 80% of the children in the series provided convincing evidence that the use of therapeutic radiation to the neck region of children is a factor in the deveiopment of thyroid cancer in some cases. Irradiation of the thyroid region during infancy and childhood is a significant factor in thyroid carcinoma in children. (P.C.H.)

Childhood thyroid carcinoma.

Childhood thyroid carcinoma.

Age and Thyroid Carcinoma

Carcinoma of the thyroid, uncommon in any age group, is one of the least common malignant neoplasms occurring in patients 14 years of age and younger. Dargeon reported 19 children with thyroid carcinoma seen during a 30-year period at the Memorial Hospital for Cancer and Allied Diseases. 1 This is 1.5% of 1,248 cases of childhood cancer seen during this interval. In contrast, at the University of Iowa Hospitals, where many fewer patients with malignant neoplasms of all ages are seen, 15 children with thyroid carcinoma have been seen during a 10-year period. The finding that between 1 in 2 and 1 in 4 nontoxic nodular goiters occurring in children are carcinoma also suggests this lesion may occur more frequently than is commonly appreciated. 2-5 The most authoritative statement on childhood thyroid carcinoma has been provided by Winship. 2,6 His world-wide survey has yielded 571 cases. The gross and microscopic

Thyroid carcinoma in childhood in Great Britain.

Thyroid carcinoma in childhood in Great Britain.

CARCINOMA OF THE THYROID IN CHILDHOOD

Data from 334 collected cases of childhood thyroid carcinoma have been compiled and studied. Possible etiologic factors are discussed, including congenital and geographic influences, and the effects of soybean diet, cobalt medication and the irradiation to the neck in infancy. The clinical and pathologic manifestations and the prevalence of this disease are discussed on the basis of the large series. Various methods of treatment and the results are reviewed. The usual 5-year follow-up period is of little value in thyroid carcinoma. Data from a 20-year follow-up of a large series of cases may indicate the best methods of therapy.