Paediatrics: Thyroid carcinoma

Thyroid carcinoma

Thyroid cancer is rare in childhood. Many carcinomas of the thyroid in the past were associated with previous direct irradiation to the head and neck tissues for other conditions. Carcinomas of the thyroid are histologically classified as being either papillary, follicular, or mixed. They are usually slow growing. Girls are affected twice as often as boys. Presentation is usually with a painless thyroid nodule. Cervical lymph node involvement is often evident at time of diagnosis. Metastases to the lung may be observed radiologically, but are usually asymptomatic. Diagnosis is established by biopsy. Radioisotope scans (¹²³I or ^99mTc) demonstrate reduced uptake. Thyroid function tests are usually normal.

Treatment and prognosis

Thyroidectomy (subtotal or complete) is indicated. Radioiodine therapy after surgery is often given. Post-ablative oral thyroid hormone replace-ment therapy is needed. Prognosis is usually very good, even with pres-ence of cervical node and/or metastases at diagnosis.