Thyroid cancer: experience at a state pediatric referral center

SUMMARY

Objective

The aim of this study was to describe the clinical-epidemiological profile and outcome in patients under 15 years of age with differentiated thyroid cancer diagnosed at a state pediatric referral service in Santa Catarina, Brazil, from 2011 to 2020.

Methods

Retrospective cohort study analyzing the medical records of 16 patients with differentiated thyroid cancer. The variables analyzed were gender, age, year of diagnosis, previous exposure to radiation, personal and family medical history, symptoms/signs at diagnosis, histological type, staging, therapy, surgical complications, remission rate, and vital status.

Results

Differentiated thyroid cancer occurred in females and adolescents in 62.5% of cases, respectively. Previous radiotherapy was reported in 25% of cases. On physical examination, 56% had a thyroid nodule. Papillary carcinoma was diagnosed in 81.25% of cases. Four patients (25%) were classified as high risk and three never achieving remission. All five low-risk patients and four of the five intermediate-risk patients were in remission. Total thyroidectomy, with or without lymph node resection, was indicated in all cases. Transient hypoparathyroidism occurred in 25%. Radioiodine therapy with I-131 was used in 68.75% of cases, including two low-risk patients treated before 2015. The remission rate was 75%. There were no deaths.

Conclusion

Papillary carcinoma is the most common histological type, predominantly in adolescents and females. Previous radiotherapy is a risk factor for differentiated thyroid cancer. The most frequent presentation is a thyroid nodule. Total thyroidectomy is the standard procedure. Radioiodine therapy is not indicated for low-risk patients after 2015. Transient hypoparathyroidism is the most common surgical complication. The remission rate for differentiated thyroid cancer is high.