DTC presentation and follow up in children and adolescents

PAPENDIECK PATRICIA; GRUÑEIRO-PAPENDIECK L; VENARA MARCELA; ACHA OSCAR; MAGLIO S; BERGADÁ IGNACIO; CHIESA ANA

JOURNAL OF PEDIATRIC ENDOCRINOLOGY AND METABOLISM

FREUND

Lugar: berlin; Año: 2011 vol. 24 p. 743 - 748

2191-0251

To review our Pediatric Endocrinology Division’s experience with DTC we analyzed retrospectively the records of patients with DTC that had been seen between 6/1988 and 6/2008. Results: 45 patients (median age 13.7 years, 36 female) were diagnosed (papillary: 40, follicular: 5) with DTC presenting as a solitary nodule (n:25), thyroid nodule with cervical adenopathy (n:9) and multinodular goiter (n:11). All underwent total thyroidectomy with resection of suspicious cervical lymph nodes (CLN). DTC was multicentric in 59% and revealed extrathyroidal extension in 44%. Initially, 44% had CLN metastases and 24% distant metastases. All patients underwent thyroid remnant ablation with 131 I and suppressive treatment. Median follow-up was 5.1 years with a disease-free survival rate at 5 years of follow up of 75 %. 11% presented recurrences. Conclusion: DTC has an aggressive behavior at presentation. Higher preoperative TSH levels were significantly associated with a more advanced disease at diagnosis. CLT was present concomitantly in ¼ of the patients and further studies are needed to establish differences in these patients’ outcome. Diagnostic approach, total thyroidectomy, 131I treatment and thyrotropin suppression allowed a good progression-free survival rate.