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Overview
Thyroid cancer occurs
in all age groups, from children and adolescents through seniors.
- Thyroid cancer
remains a rare disease in children less than age 10, with an annual
incidence of less than one per million. It is more common in older
children and adolescents, with 15.4 cases per million per year in
15-19 year olds. It has a peak incidence at age 50 and beyond.
- The number of
female adolescents with thyroid cancer has slightly increased in the
United States in recent years. Males and young children under age
15 have had no increase in incidence over the last several decades.
- The two main
types of pediatric thyroid cancer are:
- Differentiated
Thyroid Cancer: This includes papillary and follicular thyroid
cancer and their variants.Papillary thyroid cancer is the most
common type in both children and adults.
- Medullary
Thyroid Cancer. About 30% to 35% are familial tumors transmitted
by a gene from either the mother or father.
- Children and
Adolescents: Thyroid Nodules and Well-Differentiated Thyroid Cancer:
http://www.thyca.org/refbk_kids.htm
- Are There Differences
in the Presentation of Thyroid Nodules and Thyroid Cancer in Adults
and Children? http://www.thyca.org/refbk_presentation.htm
More About Differentiated
Pediatric Thyroid Cancer: Papillary and Follicular
- Because of the
lack of prospective research, differentiated thyroid cancer in children
and adolescents generally is managed similarly to that in adults.
Papillary thyroid cancer is the type of tumor that affects children
in the vast majority of cases and which, compared with other types
of thyroid cancer, has the best prognosis.
- Each case is
approached individually, to fit the needs of each patient.
- In children and
adolescents, papillary thyroid cancer tends to be more advanced at
the time of diagnosis than it is in adults with the same disease.
- The majority
of children with papillary thyroid cancer have local spread to the
lymph nodes of the neck at the time the thyroid cancer is diagnosed.
About 10% to 20% of the children have distant metastases, most commonly
to the lung, compared with only 5% of the adults with this disease.
- Recurrence of
papillary thyroid cancer is more common in children than it is in
adults.
- However, despite
higher rates of recurrence and more widespread disease at presentation,
the prognosis is excellent with appropriate treatment.
- Follicular thyroid
cancer, which is rare in children, has been reported to demonstrate
more aggressive characteristics and poorer prognosis due to vascular
invasion.
- Still, the prognosis
is better for children than for their adult counterparts who present
with a similar extent of disease.
- Follicular Thyroid
Cancer. Follicular thyroid cancer is not very common in childhood.
The primary tumor is usually a single lesion within the thyroid gland.
Lymph node metastases can occur with less differentiated variants
of follicular thyroid cancer but are not generally expected. It is
associated with a worse prognosis (as compared to papillary thyroid
carcinoma) due to its propensity for vascular invasion, which increases
the risk of metastases to distant sites of the body, such as the lungs
and bones.
- Very few children
die from this disease. Even those children with distant metastases
at diagnosis can anticipate survival for years to decades.
- The goals of
treatment are to eliminate the disease and to reduce the chance of
recurrence.
- Sometimes the
disease cannot be entirely eradicated, and therefore, another therapeutic
goal is to achieve stable disease and no symptoms of disease.
Last updated:
February 21, 2007
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