Challenges and Surgical Pitfalls in Management of Thyroid Carcinoma in Children and Adolescents

Authors

1 Pediatric Surgical Oncology, Children’s Cancer Hospital, Cairo, Egypt

2 Surgical Oncology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

3 Surgical Oncology, Faculty of Medicine, Helwan University, Cairo, Egypt

Abstract

Background: Children seldom develop thyroid cancer, although it is becoming more common. Most thyroid tumours originate in childhood, but there are some key differences, as recent research has clarified. Aim and objectives: To assess clinicopathological, radiological features and FNAC accuracy in pediatric and adolescent thyroid tumours. Assessment of intra & post-operative complications of thyroidectomy in children and adolescent thyroid carcinoma and correlate them to locoregional extension of the disease and history of previous neck radiotherapy. Patients and methods: This is an observational combined prospective and retrospective study of 89 patients with thyroid carcinoma who underwent surgical management in Children’s Cancer Hospital Egypt between January 2008 and June 2023, with at least six months of follow-up. Results: The average age of the participants was 12.8±4.4 years. Nearly two-thirds of the participants (66.3%) were Females. The majority of cases (83.1%) were papillary cancer. Multicentricity was present in 44.3%. The average largest size of the mass was 2.7±1.5cm. Nearly half of the participants (52.8%) had Lympho-vascular invasion, and 42.7% had Extra thyroid extension. Conclusion: The disease is mainly multifocal, with extra thyroid extension in the vast majority of patients. All patients who had radiotherapy should undergo clinical and radiological routine examination of the thyroid gland after 5-10 years of ending their radiotherapy to avoid missing any newly developed nodules in the gland. Pediatric thyroid carcinoma may present as a metastatic disease from the start, mainly with lung metastasis.

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