ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume: 16 Issue: 4 Year: 2024
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Abstracting & Indexing
Turkish Society for Pediatric Endocrinology and Diabetes
Differentiated Thyroid Cancer in Children and Adolescents: 12-year Experience in a Single Center [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2024; 16(3): 314-322 | DOI: 10.4274/jcrpe.galenos.2024.2024-1-25

Differentiated Thyroid Cancer in Children and Adolescents: 12-year Experience in a Single Center

Francisca Marques Puga1, Laura Correia2, Inês Vieira3, Joana Serra Caetano4, Rita Cardoso4, Isabel Dinis4, Alice Mirante4
1Unidade Local de Saúde de Santo António, Serviço de Endocrinologia, Diabetes e Metabolismo, Porto, Portugal
2Unidade Local de Saúde de Aveiro, Serviço de Pediatria, Aveiro, Portugal
3Unidade Local de Saúde de Coimbra, Serviço de Endocrinologia, Diabetes e Metabolismo, Coimbra, Portugal
4Unidade Local de Saúde de Coimbra, Hospital Pediátrico de Coimbra, Unidade de Endocrinologia Pediátrica, Diabetes e Crescimento, Coimbra, Portugal

INTRODUCTION: Differentiated thyroid cancer (DTC) is the most common pediatric endocrine cancer but studies are scarce. Latest recommendations advocate for an individualized risk-based approach to select patients for additional therapy. Lymphovascular invasion is not considered, despite being a well-known risk factor in the adult population. The aim of this study was to describe the outcomes of a cohort of DTC patients diagnosed at pediatric age and to evaluate the impact of lymphovascular invasion on the risk of persistence/recurrence.
METHODS: A retrospective study of patients diagnosed with DTC at pediatric age from 2010 to 2022 at a single center was performed. All patients had total thyroidectomy. Radioactive iodine therapy (RAI) was used in selected patients. The response to therapy and occurrence of persistent/recurrent disease were evaluated.
RESULTS: A total of 21 DTC were diagnosed, mostly papillary thyroid carcinoma (PTC) (81.0%, n=17). Six patients (28.6%) had nodal involvement and one (4.8%) had lung metastasis at the time of the diagnosis. Lymphovascular invasion was present in 11 patients (52.4%). After surgery, 13 patients (61.9%) underwent RAI. The mean follow-up time was 5.7±3.1 years. In total, 6 patients (31.6%) experienced persistent/recurrent disease during the follow-up time. Among PTC patients, persistent/recurrent disease was more frequent in the presence of lymphovascular invasion [55.6% (5/9) vs. 0.0% (0/6), p=0.031].
DISCUSSION AND CONCLUSION: An individualized risk-based approach is recommended. Our study suggests that lymphovascular invasion may be associated with a higher risk of persistence/recurrence and should therefore be considered for decision making in children and adolescents with PTC.

Keywords: Differentiated thyroid cancer, papillary thyroid cancer, children and adolescents, pediatric, lymphovascular invasion, persistence, recurrence

Corresponding Author: Francisca Marques Puga, Portugal
Manuscript Language: English
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