Akademik Veri Yönetim Sistemi
The 61st Annual ESPE Meeting 2023, The Hague, Hollanda, 21 - 23 Eylül 2023, ss.447
Introduction: Thyroid cancers are rare malignancies in childhood and their incidence is between 1.5-3% among all childhood
cancers. Papillary thyroid cancer (PTC) constitutes more than 90%
of childhood thyroid cancers. Risk factors for thyroid cancer
include; There are iodine deficiency, radiation exposure, radiotherapy to the head and neck region, and genetic predisposition.
We will present an 8-year-old case who presented with a complaint
of neck swelling and was found to have papillary thyroid carcinoma as a result of the examinations.
Case: An 8-year-old female patient presented with a swelling in
the neck that appeared 1 month ago. No features were found in the
resume and family history. On physical examination, height: 135.6
cm (sds: 0.97); weight:30 kg (sds:0.51); body mass index: 16.3;
Thyroid grade 3 palpable; S1+ S2+ rhythmic, T1 P1 detected. In
the examinations of the patient, fT3: 4.65 ng/dl, fT4: 1.1 ng/dl,
TSH: 3.69 mIU/L, thyroglobulin: 421 ng/dl. Thyroid USG results
taken in an external center: 6x2.5x4 cm solid formation containing
dense vascular multiple punctate calcifications in the right thyroid
lobe, 19x14.5x23 mm in size in the inferior of the left thyroid lobe,
hypoechoic suspicious spherical lymph node showing peripheral
vascularization and reaching 25x12 mm in the right supraclavicular area. A peripheral suspicious pathological lymph node with
moderate vascularization, whose central fatty hilum could not be
discerned, was detected. Thorax CT: Nodular lesions were observed
in both lungs, which may be significant in terms of multiple millimetric metastases. Thyroid FNAB pathology resulted as papillary
thyroid carcinoma. Total thyroidectomy and lymph node dissection were planned by the pediatric surgeon. During the operation,
thyroid right lobectomy, isthmusectomy, modified radical cervical
lymph node dissection were performed due to recurrent laryngeal
nerve tumor invasion. Complementary left lobectomy left modified radical cervical lymph node dissection was performed in the
patient who had no signs of laryngeal nerve damage in the followup. Pathology report: Thyroid papillary thyroid carcinoma, diffuse
sclerosing variant was detected.
Radioactive iodine was planned due to distant metastasis. 100
mci RAI treatment was given by the Nuclear Medicine Department.
The patient’s follow-up continues with the Department of Pediatric
Endocrinology, Pediatric Surgery and Nuclear Medicine.
Conclusion: Papillary thyroid carcinoma is rare in childhood.
Papillary thyroid carcinoma seen in children has a more aggressive
course compared to adults, and lymph node metastases, extension
outside the thyroid, and lung metastases at the time of diagnosis
are more common than adults.