E-ISSN: 2791-8823
Volume: 14 Issue: 1 Year: 2022
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Turkish Society for Pediatric Endocrinology and Diabetes
Long-term Follow-up of a Toddler with Papillary Thyroid Carcinoma: A Case Report with a Literature Review of Patients Under 5 Years of Age [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2022; 14(1): 119-125 | DOI: 10.4274/jcrpe.galenos.2020.2020.0178

Long-term Follow-up of a Toddler with Papillary Thyroid Carcinoma: A Case Report with a Literature Review of Patients Under 5 Years of Age

Ayşe Pınar Öztürk1, Esin Karakılıç Özturan1, Feryal Gün Soysal2, Seher Ünal3, Göknur Işık3, Gülçin Yeğen4, Semen Önder4, Melek Yıldız1, Şükran Poyrazoğlu1, Firdevs Baş1, Feyza Darendeliler1
1İstanbul University, İstanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Turkey
2İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Surgery, İstanbul, Turkey
3İstanbul University, İstanbul Faculty of Medicine, Department of Nuclear Medicine, İstanbul, Turkey
4İstanbul University, İstanbul Faculty of Medicine, Department of Pathology, İstanbul, Turkey

Papillary thyroid cancer (PTC) is extremely rare in children. Herein, we present a case diagnosed with PTC at 15 months of age. We conducted a literature review of the published cases with PTC under five years of age. A 1.25-year-old male patient had initially presented with a complaint of progressively enlarging cervical mass that appeared four months earlier. On physical examination, a mass located in the anterior cervical region with the largest measurements of around 3x3 cm was detected. Cervical and thyroid ultrasonography showed a 50x27 mm solid mass in the right lateral neck. Excisional biopsy revealed a follicular variant of PTC with capsular invasion. Subsequently, he underwent a complementary total thyroidectomy. He was diagnosed with intermediate-risk (T3N0M0) PTC. He developed permanent hypoparathyroidism. In the first year of the operation, he was treated with radioiodine ablation (RAI) since basal and stimulated thyroglobulin (Tg) levels tended to increase. Whole-body scintigraphy was normal in the first year of RAI ablation. On levothyroxine sodium (LT4) treatment, levels of thyroid stimulating hormone (TSH) and Tg were adequately suppressed. He is now 8.5-years-old and disease-free on LT4 replacement therapy for seven years and three months. Pediatric PTC has different biological behavior and an excellent prognosis compared to adults. The optimal treatment strategy for pediatric TC is total thyroidectomy, followed by RAI ablation. Post-operative management should include regular follow-up, TSH suppression by adequate LT4 therapy, serial Tg evaluation, and radioiodine scanning when indicated.

Keywords: Papillary carcinoma, thyroid, children

Ayşe Pınar Öztürk, Esin Karakılıç Özturan, Feryal Gün Soysal, Seher Ünal, Göknur Işık, Gülçin Yeğen, Semen Önder, Melek Yıldız, Şükran Poyrazoğlu, Firdevs Baş, Feyza Darendeliler. Long-term Follow-up of a Toddler with Papillary Thyroid Carcinoma: A Case Report with a Literature Review of Patients Under 5 Years of Age. J Clin Res Pediatr Endocrinol. 2022; 14(1): 119-125

Corresponding Author: Ayşe Pınar Öztürk, Türkiye
Manuscript Language: English
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