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.
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.
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