Background and Aim
Thyroid carcinomas are recurrent in childhood and adolescence over the last three decades in some European countries. This evolution seems to be unfair in the world and the management of this entity remains controversial. The purpose of this study is to review analytically and descriptively all the cases managed at Institute of Oncology, Cluj-Napoca (IOCN) in Romania.
The medical records of all patients with thyroid cancer younger than 20 years who presented to IOCN between June 2010 and December 2017 were reviewed.
Forty patients with thyroid carcinoma (TC) were identified (papillary 68%; Mixed 28% Medullary 2% and Folicullary 2%). No patient had previous exposure to medical ionizing radiation. The mean age at diagnosis was 15.75 years. Children born between 10 and 15 years after the Chernobyl accident are the most affected (65%). There were 10 males and 30 females; all patients presented with a nodular goiter. Four were on stage II of ATA and 36 Stage I. Thirty seven patients underwent total thyroidectomy, 1 subtotal thyroidectomy and 2 lobectomy. Twenty one patients (52.5%) had regional lymph node metastases, 4 of whom (7.6%) had lung metastases. All presented post-operative myxedema. Thirty three received radioactive “131I” ablation postsurgical (activity between 38.85mCi -117mCi). Eleven (27.5%) had recurrences and needed multiple surgeries and/or “131I” ablation (1-8 doses). The total activity recived was between 38.85 and 834.04mCi. Three patients shall be traeted with TKIs protocole.
Pediatric thyroid cancer in Romania is not a rare tumor since the Chernobyl accident. The main clinical presentation is a cervical mass with locoregional lymph node metastases. The mainstay of therapy is total thyroidectomy with lymph node dissection when indicated and radioactive “131I” ablation. Despite the recurrences, and resistance to radio-iodine in some, the prognosis is excellent.Le texte complet de cet article est disponible en PDF.
Mots clés : Cancer Médullaire de la Thyroïde
Vol 43 - N° 2P. 196-197 - mars 2019 Retour au numéro
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