Thyroid Carcinoma in Children and Young Adults: Retrospective Review of 19 Cases

Detalhes bibliográficos
Autor(a) principal: Saraiva, Joana
Data de Publicação: 2013
Outros Autores: Ribeiro, Cristina, Melo, Miguel, Gomes, Leonor, Costa, Gracinda, Carrilho, Francisco
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1307
Resumo: Introduction: Thyroid carcinoma is rare in children and young adults. Most of management guidelines are based in data from adult population. Several controversies remain regarding the aggressiveness of clinical presentation and therapeutic approach.Objective: To evaluate all differentiated thyroid carcinoma patients with less than 20 years-old at presentation reflecting the experience of our unit in relation to diagnosis, treatment and follow-up of this clinical entity.Material and Methods: This is a retrospective review of clinical records of all children and young adults followed at Oncology Consultation of Department of Endocrinology of Centro Hospitalar e Universitário de Coimbra between 1996 and 2012.Results: Nineteen patients with mean age of 16 years old were followed, 13 girls and 6 boys. None of the patients had previous neck irradiation. A palpable cervical mass was the presenting complaint in 84.6%. FNA was performed in 15 patients and was diagnostic or suspicious of malignancy in 71.4%. Total thyroidectomy was performed in 18 cases (94.7%). Papillary carcinoma was identified in all. Vascular invasion and multicentry occurred in 21.1%. Mean tumor size was 2.5cm. Cervical lymph node involvement was diagnosed in 31.6% and distant metastases in 5.2%. The majority of patients (18 in 19) were classified as stage I disease. All patients received thyroxine suppressive therapy and postoperative radioiodine ablation was given to 84.2% (mean dose 85.7mCi). During mean follow-upof almost 6 years, 16 patients remain disease free.Conclusion: In our series, cervical lymph node and distant metastases rates were similar to that found in adult population. Overall prognosis was very good.
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spelling Thyroid Carcinoma in Children and Young Adults: Retrospective Review of 19 CasesCarcinoma da Tiróide em Crianças e Jovens Adultos: Revisão Retrospectiva de 19 CasosIntroduction: Thyroid carcinoma is rare in children and young adults. Most of management guidelines are based in data from adult population. Several controversies remain regarding the aggressiveness of clinical presentation and therapeutic approach.Objective: To evaluate all differentiated thyroid carcinoma patients with less than 20 years-old at presentation reflecting the experience of our unit in relation to diagnosis, treatment and follow-up of this clinical entity.Material and Methods: This is a retrospective review of clinical records of all children and young adults followed at Oncology Consultation of Department of Endocrinology of Centro Hospitalar e Universitário de Coimbra between 1996 and 2012.Results: Nineteen patients with mean age of 16 years old were followed, 13 girls and 6 boys. None of the patients had previous neck irradiation. A palpable cervical mass was the presenting complaint in 84.6%. FNA was performed in 15 patients and was diagnostic or suspicious of malignancy in 71.4%. Total thyroidectomy was performed in 18 cases (94.7%). Papillary carcinoma was identified in all. Vascular invasion and multicentry occurred in 21.1%. Mean tumor size was 2.5cm. Cervical lymph node involvement was diagnosed in 31.6% and distant metastases in 5.2%. The majority of patients (18 in 19) were classified as stage I disease. All patients received thyroxine suppressive therapy and postoperative radioiodine ablation was given to 84.2% (mean dose 85.7mCi). During mean follow-upof almost 6 years, 16 patients remain disease free.Conclusion: In our series, cervical lymph node and distant metastases rates were similar to that found in adult population. Overall prognosis was very good.Introdução: O carcinoma da tiróide é raro em crianças e em adultos jovens. A maior parte das orientações clínicas baseia-se em dados obtidos na população adulta. Persistem diversas controvérsias no que se refere à agressividade da apresentação clínica e da abordagem terapêutica.Objectivo: Avaliar todos os doentes com carcinoma da tiróide com menos de 20 anos no momento da apresentação, reflectindo a experiência da nossa unidade relativamente ao diagnóstico, tratamento e seguimento desta entidade.Material e Métodos: Trata-se de um estudo de revisão retrospectiva dos registos clínicos de todas as crianças e adultos jovens seguidos na Consulta de Oncologia do Serviço de Endocrinologia do Centro Hospitalar e Universitário de Coimbra entre 1996 e 2012 .Resultados: Foram estudados 19 doentes, com uma média etária de 16 anos, sendo 13 do sexo feminino. Nenhum dos doentes fora previamente submetido a irradiação da região do pescoço. A queixa de apresentação era a presença de uma massa cervical palpável em 84,6% dos casos. Foi realizada citologia aspirativa em 15 doentes, que foi diagnóstica ou suspeita de neoplasia em 71,4% dos casos. A tiroidectomia total foi levada a cabo em 18 casos (94,7%). Em todos estes foi identificada a presença de um carcinoma papilar. A invasão vascular e multicêntrica ocorreu em 21,1% dos casos. A dimensão tumoral média foi de 2,5 cm. O envolvimento ganglionar cervical foi diagnosticado em 31,6% dos casos e a presença de metástases à distância foi identificada em 5,2% dos casos. Na maior parte dos doentes (18 em 19), o quadro foi classificado como doença em estadio I. Todos os doentes fizeram terapêutica supressora com tiroxina e 84,2% dos doentes foram submetidos a ablação pós-operatória com iodo radioactivo (dose média de 85,7mCi). Durante um seguimento médio de cerca de 6 anos, 16 doentes permaneceram em remissão.Conclusão: Na nossa série, as taxas de metastização ganglionar cervical e à distância foram semelhantes às encontradas na população adulta. O prognóstico foi globalmente muito satisfatório.Ordem dos Médicos2013-10-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1307oai:ojs.www.actamedicaportuguesa.com:article/1307Acta Médica Portuguesa; Vol. 26 No. 5 (2013): September-October; 578-582Acta Médica Portuguesa; Vol. 26 N.º 5 (2013): Setembro-Outubro; 578-5821646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1307https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1307/3778Saraiva, JoanaRibeiro, CristinaMelo, MiguelGomes, LeonorCosta, GracindaCarrilho, Franciscoinfo:eu-repo/semantics/openAccess2022-12-20T10:57:45Zoai:ojs.www.actamedicaportuguesa.com:article/1307Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:17:04.677599Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Thyroid Carcinoma in Children and Young Adults: Retrospective Review of 19 Cases
Carcinoma da Tiróide em Crianças e Jovens Adultos: Revisão Retrospectiva de 19 Casos
title Thyroid Carcinoma in Children and Young Adults: Retrospective Review of 19 Cases
spellingShingle Thyroid Carcinoma in Children and Young Adults: Retrospective Review of 19 Cases
Saraiva, Joana
title_short Thyroid Carcinoma in Children and Young Adults: Retrospective Review of 19 Cases
title_full Thyroid Carcinoma in Children and Young Adults: Retrospective Review of 19 Cases
title_fullStr Thyroid Carcinoma in Children and Young Adults: Retrospective Review of 19 Cases
title_full_unstemmed Thyroid Carcinoma in Children and Young Adults: Retrospective Review of 19 Cases
title_sort Thyroid Carcinoma in Children and Young Adults: Retrospective Review of 19 Cases
author Saraiva, Joana
author_facet Saraiva, Joana
Ribeiro, Cristina
Melo, Miguel
Gomes, Leonor
Costa, Gracinda
Carrilho, Francisco
author_role author
author2 Ribeiro, Cristina
Melo, Miguel
Gomes, Leonor
Costa, Gracinda
Carrilho, Francisco
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Saraiva, Joana
Ribeiro, Cristina
Melo, Miguel
Gomes, Leonor
Costa, Gracinda
Carrilho, Francisco
description Introduction: Thyroid carcinoma is rare in children and young adults. Most of management guidelines are based in data from adult population. Several controversies remain regarding the aggressiveness of clinical presentation and therapeutic approach.Objective: To evaluate all differentiated thyroid carcinoma patients with less than 20 years-old at presentation reflecting the experience of our unit in relation to diagnosis, treatment and follow-up of this clinical entity.Material and Methods: This is a retrospective review of clinical records of all children and young adults followed at Oncology Consultation of Department of Endocrinology of Centro Hospitalar e Universitário de Coimbra between 1996 and 2012.Results: Nineteen patients with mean age of 16 years old were followed, 13 girls and 6 boys. None of the patients had previous neck irradiation. A palpable cervical mass was the presenting complaint in 84.6%. FNA was performed in 15 patients and was diagnostic or suspicious of malignancy in 71.4%. Total thyroidectomy was performed in 18 cases (94.7%). Papillary carcinoma was identified in all. Vascular invasion and multicentry occurred in 21.1%. Mean tumor size was 2.5cm. Cervical lymph node involvement was diagnosed in 31.6% and distant metastases in 5.2%. The majority of patients (18 in 19) were classified as stage I disease. All patients received thyroxine suppressive therapy and postoperative radioiodine ablation was given to 84.2% (mean dose 85.7mCi). During mean follow-upof almost 6 years, 16 patients remain disease free.Conclusion: In our series, cervical lymph node and distant metastases rates were similar to that found in adult population. Overall prognosis was very good.
publishDate 2013
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dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 26 No. 5 (2013): September-October; 578-582
Acta Médica Portuguesa; Vol. 26 N.º 5 (2013): Setembro-Outubro; 578-582
1646-0758
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