Pediatric Thyroid Cancer

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/about/TCGuide/refbk_kids/
  • Are There Differences in the Presentation of Thyroid Nodules and Thyroid Cancer in Adults and Children? http://www.thyca.org/about/TCGuide/refbk_presentation/

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