Course of papillary thyroid carcinoma diagnosed in childhood and adolescence and followed through adulthood: experience from a tertiary referral center

Objective: Differentiated thyroid cancer accounts for 1.5% of all pediatric malignancies. Papillary thyroid cancer (PTC) is the most common subtype and is associated with more advanced disease at diagnosis compared to adults. This study aimed to identify long-term outcomes of pediatric PTC.Material and Method: Records of 30 patients with PTC diagnosed in childhood and adolescence and followed up at the Istanbul Faculty of Medicine were reviewed retrospectively.Result: The mean age of 30 patients (21 females, 9 males) at diagnosis was 14.7 +/- 2.3 years. The mean duration of follow-up was 10.6 +/- 3.8 years. The patients underwent total thyroidectomy (n=9), total thyroidectomy with central lymph node dissection (n=9), or total thyroidectomy with central and lateral lymph node dissection (n=12). The mean tumor diameter was 1.6 +/- 1.5 cm and was microcarcinoma in 12 of the patients. There were five patients with T2 and two patients with T3 disease. At diagnosis, half of the patients had lymph node metastasis to the neck or upper mediastinum (N1a=5, N1b=10), and two also had lung metastasis. Post-operative radioactive iodine (RAI) treatment was administered to 22 patients, the median cumulative dose was 150 mCi (range 50 to 1100)]. Sixteen patients had excellent responses following single (n=13) or multiple (2 for persistent and 1 for recur-ring disease after 8.3 years) RAI administrations. The remaining three patients had structural incomplete and three had indeterminate responses.Conclusion: Although PTC presented at a more advanced stage in childhood and adolescence, the response to treatment was fairly good with appropriate management.