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Original Article

Thyroid Cancer in Pediatric Age: A Single Institution Experience

Hyo-Jun Kim1, Ji-Won Han1, Joong Kee Youn1, Hee-Beom Yang1, Chaeyoun Oh1, Hyun-Young Kim2, Sung-Eun Jung2, Kwi-Won Park3
Journal of the Korean Association of Pediatric Surgeons 2017;23(2):42-47.
Published online: December 20, 2017

1Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea.

2Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Korea.

3Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

Correspondence: Hyun-Young Kim, Department of Pediatric Surgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-2072-2478, Fax: +82-2-747-5130, spkhy02@snu.ac.kr
• Received: July 17, 2017   • Revised: September 5, 2017   • Accepted: September 23, 2017

Copyright © 2017 Korean Association of Pediatric Surgeons

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    Thyroid cancer is a rare disease in pediatric population, but its incidence rate is increasing. The aim of this report is to present a single institution experience of pediatric thyroid cancer and to identify clinical features, predisposing factors, and postoperative course of pediatric thyroid cancer.
  • Methods
    We retrospectively reviewed 35 pediatric patients who underwent operation due to thyroid cancer at Seoul National University Children's Hospital between May 1997 and January 2017. The median follow-up period was 70 months (range, 5–238 months).
  • Results
    The mean age at operation was 12.0±5.91 years and 27 patients were female. The underlying conditions in patients included history of chemoradiotherapy for previous other malignancies (n=4), hypothyroidism (n=3), history of chemotherapy (n=2), family history of thyroid cancer (n=1) and history of radiation therapy (n=1). The initial symptoms were palpable neck mass (n=21) and incidental findings (n=11). Total thyroidectomy (n=30) or unilateral lobectomy (n=5) were performed. There were 15 postoperative complications including transient hypocalcemia in 14 patients and Horner's syndrome in 1 patient. The most common pathologic cell type was papillary thyroid cancer (n=29). Extrathyroid extension and lymph node invasion were found in 25 patients and 27 patients, respectively. Thirteen patients showed multifocality. During follow-up period, 5 patients underwent additional operation because of tumor recurrence in lymph nodes. Lung metastasis was detected in 3 patients at the time of diagnosis and in 3 patients during follow-up period. The mortality rate was zero and mean disease-free survival was 83.7±47.9 months.
  • Conclusion
    Pediatric thyroid cancer has lower mortality rate and recurrence rate as seen in this study despite the advanced stage at diagnosis. A thorough follow-up of patients with an underlying condition such as history of chemoradiotherapy and understanding new pediatric guideline can be helpful to maximize patients' survival and prognosis.
  • Keywords: Thyroid neoplasms; Pediatrics; Thyroidectomy

No potential conflict of interest relevant to this article was reported.

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Fig. 1

Disease-free survival.

jkaps-23-42-g001.jpg
Table 1

Clinical Characteristics of Patients (n=35)

Values are presented as mean±SD or n (%).

LN, lymph node; FNA, fine needle aspiration.

jkaps-23-42-i001.jpg
Table 2

Operation (n=35)

Values are presented as mean±SD or n (%).

CLND, central lymph node dissection; LN, lymph node.

jkaps-23-42-i002.jpg
Table 3

Pathology Results (n=35)

Values are presented as n (%) or mean±SD.

LN, lymph node.

jkaps-23-42-i003.jpg
Table 4

Postoperative Course (n=35)

Values are presented as n (%), median (range), or mean±SD.

RAI, radioactive iodine; LN, lymph node; MRND, modified radical neck dissection.

a)Fivepatients underwent lymph node dissection due to recurrence.

b)Period between first operation and reoperation.

jkaps-23-42-i004.jpg
Table 5

Reoperation Cases

F, female; M, male; TT, total thyroidectomy; CND, central node dissection; LND, lateral node dissection; PTC, papillary thyroid cancer; ETE, extrathyroid extension; LN, lymph node; RAI, radioactive iodine.

jkaps-23-42-i005.jpg

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Thyroid Cancer in Pediatric Age: A Single Institution Experience
J Korean Assoc Pediatr Surg. 2017;23(2):42-47.   Published online December 20, 2017
DOI: https://doi.org/10.13029/jkaps.2017.23.2.42
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Thyroid Cancer in Pediatric Age: A Single Institution Experience
J Korean Assoc Pediatr Surg. 2017;23(2):42-47.   Published online December 20, 2017
DOI: https://doi.org/10.13029/jkaps.2017.23.2.42
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Thyroid Cancer in Pediatric Age: A Single Institution Experience
Image
Fig. 1 Disease-free survival.

Fig. 1

Thyroid Cancer in Pediatric Age: A Single Institution Experience

Clinical Characteristics of Patients (n=35)

Values are presented as mean±SD or n (%).

LN, lymph node; FNA, fine needle aspiration.

Operation (n=35)

Values are presented as mean±SD or n (%).

CLND, central lymph node dissection; LN, lymph node.

Pathology Results (n=35)

Values are presented as n (%) or mean±SD.

LN, lymph node.

Postoperative Course (n=35)

Values are presented as n (%), median (range), or mean±SD.

RAI, radioactive iodine; LN, lymph node; MRND, modified radical neck dissection.

a)Fivepatients underwent lymph node dissection due to recurrence.

b)Period between first operation and reoperation.

Reoperation Cases

F, female; M, male; TT, total thyroidectomy; CND, central node dissection; LND, lateral node dissection; PTC, papillary thyroid cancer; ETE, extrathyroid extension; LN, lymph node; RAI, radioactive iodine.

Table 1 Clinical Characteristics of Patients (n=35)

Values are presented as mean±SD or n (%).

LN, lymph node; FNA, fine needle aspiration.

Table 2 Operation (n=35)

Values are presented as mean±SD or n (%).

CLND, central lymph node dissection; LN, lymph node.

Table 3 Pathology Results (n=35)

Values are presented as n (%) or mean±SD.

LN, lymph node.

Table 4 Postoperative Course (n=35)

Values are presented as n (%), median (range), or mean±SD.

RAI, radioactive iodine; LN, lymph node; MRND, modified radical neck dissection.

a)Fivepatients underwent lymph node dissection due to recurrence.

b)Period between first operation and reoperation.

Table 5 Reoperation Cases

F, female; M, male; TT, total thyroidectomy; CND, central node dissection; LND, lateral node dissection; PTC, papillary thyroid cancer; ETE, extrathyroid extension; LN, lymph node; RAI, radioactive iodine.

Table 1

Table 2

Table 3

Table 4

Table 5

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