Skip to main content

Thyroid Cancer in Children

  • Chapter
  • First Online:
Endocrine Surgery in Children

Abstract

This chapter reviews thyroid cancer in children. It concentrates on differentiated thyroid cancer that arises from thyroid follicle cells, especially papillary thyroid cancer. The other major differentiated thyroid cancer, follicular cell carcinoma, is also discussed but other thyroid cancers are only briefly mentioned. Discussions of thyroid cancer in children are often dominated by extrapolations of data from adults because thyroid cancer is so much more common in adults than children. But thyroid cancer in children is not the same as thyroid cancer in adults. There are different etiologies, risk factors, clinical presentations, and natural histories. The unique aspects of thyroid cancer in children have been recognized and in 2015 the American Thyroid Association published specific recommendations regarding the evaluation and management of thyroid cancer in children 18 years of age and younger.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Francis GL, Waguespack SG, Bauer AJ, Angelos P, Benvenga S, Cerutti JM, Dinauer CA, Hamilton J, Hay ID, Luster M, Parisi MT, Rachmiel M, Thompson GB, Yamashita S. Management guidelines for children with thyroid nodules and differentiated thyroid cancer. Thyroid. 2015;25:716–59.

    Article  PubMed  PubMed Central  Google Scholar 

  2. American Thyroid Association Guidelines Taskforce on Thyroid N, Differentiated Thyroid C, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, Mciver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19:1167–214.

    Google Scholar 

  3. Rivkees SA, Mazzaferri EL, Verburg FA, Reiners C, Luster M, Breuer CK, Dinauer CA, Udelsman R. The treatment of differentiated thyroid cancer in children: emphasis on surgical approach and radioactive iodine therapy. Endocr Rev. 2011;32:798–826.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Parisi MT, Mankoff D. Differentiated pediatric thyroid cancer: correlates with adult disease, controversies in treatment. Semin Nucl Med. 2007;37:340–56.

    Article  PubMed  Google Scholar 

  5. Hogan AR, Zhuge Y, Perez EA, Koniaris LG, Lew JI, Sola JE. Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients. J Surg Res. 2009;156:167–72.

    Article  PubMed  Google Scholar 

  6. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA. 2006;295:2164–7.

    Article  CAS  PubMed  Google Scholar 

  7. Wu XC, Chen VW, Steele B, Roffers S, Klotz JB, Correa CN, Carozza SE. Cancer incidence in adolescents and young adults in the United States, 1992–1997. J Adolesc Health. 2003;32:405–15.

    Article  PubMed  Google Scholar 

  8. Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011;61:212–36.

    Article  PubMed  Google Scholar 

  9. Bleyer A, Viny A, Barr R. Cancer in 15- to 29-year-olds by primary site. Oncologist. 2006;11:590–601.

    Article  PubMed  Google Scholar 

  10. Cramer JD, Fu P, Harth KC, Margevicius S, Wilhelm SM. Analysis of the rising incidence of thyroid cancer using the surveillance, epidemiology and end results national cancer data registry. Surgery. 2010;148:1147–52 (discussion 1152–3).

    Google Scholar 

  11. Enewold L, Zhu K, Ron E, Marrogi AJ, Stojadinovic A, Peoples GE, Devesa SS. Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980–2005. Cancer Epidemiol Biomarkers Prev. 2009;18:784–91.

    Google Scholar 

  12. Aschebrook-Kilfoy B, Ward MH, Sabra MM, Devesa SS. Thyroid cancer incidence patterns in the United States by histologic type, 1992–2006. Thyroid. 2011;21:125–34.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Ron E, Lubin JH, Shore RE, Mabuchi K, Modan B, Pottern LM, Schneider AB, Tucker MA, Boice JD Jr. Thyroid cancer after exposure to external radiation: a pooled analysis of seven studies. Radiat Res. 1995;178:AV43-60.

    Google Scholar 

  14. Schonfeld SJ, Lee C, de Gonzalez AB. Medical exposure to radiation and thyroid cancer. Clin Oncol (R Coll Radiol). 2011;244–50.

    Google Scholar 

  15. Ron E, Saftlas AF. Head and neck radiation carcinogenesis: epidemiologic evidence. Otolaryngol Head Neck Surg. 1996;115:403–8.

    CAS  PubMed  Google Scholar 

  16. Ronckers CM, Sigurdson AJ, Stovall M, Smith SA, Mertens AC, Liu Y, Hammond S, Land CE, Neglia JP, Donaldson SS, Meadows AT, Sklar CA, Robison LL, Inskip PD. Thyroid cancer in childhood cancer survivors: a detailed evaluation of radiation dose response and its modifiers. Radiat Res. 2006;166:618–28.

    Article  CAS  PubMed  Google Scholar 

  17. Taylor AJ, Croft AP, Palace AM, Winter DL, Reulen RC, Stiller CA, Stevens MC, Hawkins MM. Risk of thyroid cancer in survivors of childhood cancer: results from the British Childhood Cancer Survivor Study. Int J Cancer. 2009;125:2400–5.

    Article  CAS  PubMed  Google Scholar 

  18. Schneider AB, Bekerman C, Leland J, Rosengarten J, Hyun H, Collins B, Shore-Freedman E, Gierlowski TC. Thyroid nodules in the follow-up of irradiated individuals: comparison of thyroid ultrasound with scanning and palpation. J Clin Endocrinol Metab. 1997;82:4020–7.

    CAS  PubMed  Google Scholar 

  19. Jacob P, Goulko G, Heidenreich WF, Likhtarev I, Kairo I, Tronko ND, Bogdanova TI, Kenigsberg J, Buglova E, Drozdovitch V, Golovneva A, Demidchik EP, Balonov M, Zvonova I, Beral V. Thyroid cancer risk to children calculated. Nature. 1998;392:31–2.

    Article  CAS  PubMed  Google Scholar 

  20. Tronko MD, Howe GR, Bogdanova TI, Bouville AC, Epstein OV, Brill AB, Likhtarev IA, Fink DJ, Markov VV, Greenebaum E, Olijnyk VA, Masnyk IJ, Shpak VM, McConnell RJ, Tereshchenko VP, Robbins J, Zvinchuk OV, Zablotska LB, Hatch M, Luckyanov NK, Ron E, Thomas TL, Voilleque PG, Beebe GW. A cohort study of thyroid cancer and other thyroid diseases after the Chornobyl accident: thyroid cancer in Ukraine detected during first screening. J Natl Cancer Inst. 2006;98:897–903.

    Article  PubMed  Google Scholar 

  21. Schneider AB. Radiation-induced thyroid tumors. Endocrinol Metab Clin North Am. 1990;19:495–508.

    CAS  PubMed  Google Scholar 

  22. Herraiz M, Barbesino G, Faquin W, Chan-Smutko G, Patel D, Shannon KM, Daniels GH, Chung DC. Prevalence of thyroid cancer in familial adenomatous polyposis syndrome and the role of screening ultrasound examinations. Clin Gastroenterol Hepatol. 2007;5:367–73.

    Article  PubMed  Google Scholar 

  23. Ngeow J, Mester J, Rybicki LA, Ni Y, Milas M, Eng C. Incidence and clinical characteristics of thyroid cancer in prospective series of individuals with Cowden and Cowden-like syndrome characterized by germline PTEN, SDH, or KLLN alterations. J Clin Endocrinol Metab. 2011;96:E2063–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Smith JR, Marqusee E, Webb S, Nose V, Fishman SJ, Shamberger RC, Frates MC, Huang SA. Thyroid nodules and cancer in children with PTEN hamartoma tumor syndrome. J Clin Endocrinol Metab. 2011;96:34–7.

    Article  CAS  PubMed  Google Scholar 

  25. Hall JE, Abdollahian DJ, Sinard RJ. Thyroid disease associated with Cowden syndrome: a meta-analysis. Head Neck. 2013;35:1189–94.

    Article  PubMed  Google Scholar 

  26. Stratakis CA, Courcoutsakis NA, Abati A, Filie A, Doppman JL, Carney JA, Shawker T. Thyroid gland abnormalities in patients with the syndrome of spotty skin pigmentation, myxomas, endocrine overactivity, and schwannomas (Carney complex). J Clin Endocrinol Metab. 1997;82:2037–43.

    Article  CAS  PubMed  Google Scholar 

  27. Doros L, Schultz KA, Stewart DR, Bauer AJ, Williams G, Rossi CT, Carr A, Yang J, Dehner LP, Messinger Y, Hill DA. DICER1-related disorders. In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, Bird TD, Ledbetter N, Mefford HC, Smith RJH, Stephens K (eds) GeneReviews (R), Seattle, WA; 1993.

    Google Scholar 

  28. de Kock L, Sabbaghian N, Soglio DB, Guillerman RP, Park BK, Chami R, Deal CL, Priest JR, Foulkes WD. Exploring the association between DICER1 mutations and differentiated thyroid carcinoma. J Clin Endocrinol Metab. 2014;99:E1072–7.

    Article  PubMed  Google Scholar 

  29. Bonora E, Tallini G, Romeo G. Genetic predisposition to familial nonmedullary thyroid cancer: an update of molecular findings and state-of-the-art studies. J Oncol. 2010;2010:385206.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Gara SK, Jia L, Merino MJ, Agarwal SK, Zhang L, Cam M, Patel D, Kebebew E. Germline HABP2 mutation causing familial nonmedullary thyroid cancer. N Engl J Med. 2015;373:448–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Moses W, Weng J, Kebebew E. Prevalence, clinicopathologic features, and somatic genetic mutation profile in familial versus sporadic nonmedullary thyroid cancer. Thyroid. 2011;21:367–71.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Delellis RA. Pathology and genetics of thyroid carcinoma. J Surg Oncol. 2006;94:662–9.

    Article  CAS  PubMed  Google Scholar 

  33. Harness JK, Thompson NW, Mcleod MK, Pasieka JL, Fukuuchi A. Differentiated thyroid carcinoma in children and adolescents. World J Surg. 1992;16:547–53 (discussion 553–4).

    Google Scholar 

  34. Halac I, Zimmerman D. Thyroid nodules and cancers in children. Endocrinol Metab Clin North Am. 2005;34:725–44, x.

    Google Scholar 

  35. Gupta A, Ly S, Castroneves LA, Frates MC, Benson CB, Feldman HA, Wassner AJ, Smith JR, Marqusee E, Alexander EK, Barletta J, Doubilet PM, Peters HE, Webb S, Modi BP, Paltiel HJ, Kozakewich H, Cibas ES, Moore Jr FD, Shamberger RC, Larsen PR, Huang SA. A standardized assessment of thyroid nodules in children confirms higher cancer prevalence than in adults. J Clin Endocrinol Metab. 2013;98:3238–45.

    Google Scholar 

  36. Koo JS, Hong S, Park CS. Diffuse sclerosing variant is a major subtype of papillary thyroid carcinoma in the young. Thyroid. 2009;19:1225–31.

    Article  PubMed  Google Scholar 

  37. Demidchik YE, Demidchik EP, Reiners C, Biko J, Mine M, Saenko VA, Yamashita S. Comprehensive clinical assessment of 740 cases of surgically treated thyroid cancer in children of Belarus. Ann Surg. 2006;243:525–32.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Zimmerman D, Hay ID, Gough IR, Goellner JR, Ryan JJ, Grant CS, McConahey WM. Papillary thyroid carcinoma in children and adults: long-term follow-up of 1039 patients conservatively treated at one institution during three decades. Surgery. 1988;104:1157–66.

    CAS  PubMed  Google Scholar 

  39. Savio R, Gosnell J, Palazzo FF, Sywak M, Agarwal G, Cowell C, Shun A, Robinson B, Delbridge LW. The role of a more extensive surgical approach in the initial multimodality management of papillary thyroid cancer in children. J Pediatr Surg. 2005;40:1696–700.

    Article  PubMed  Google Scholar 

  40. Jarzab B, Handkiewicz Junak D, Wloch J, Kalemba B, Roskosz J, Kukulska A, Puch Z. Multivariate analysis of prognostic factors for differentiated thyroid carcinoma in children. Eur J Nucl Med. 2000;27:833–41.

    Google Scholar 

  41. Chow SM, Law SC, Mendenhall WM, Au SK, Yau S, Mang O, Lau WH. Differentiated thyroid carcinoma in childhood and adolescence-clinical course and role of radioiodine. Pediatr Blood Cancer. 2004;42:176–83.

    Article  PubMed  Google Scholar 

  42. Vassilopoulou-Sellin R, Klein MJ, Smith TH, Samaan NA, Frankenthaler RA, Goepfert H, Cangir A, Haynie TP. Pulmonary metastases in children and young adults with differentiated thyroid cancer. Cancer. 1993;71:1348–52.

    Article  CAS  PubMed  Google Scholar 

  43. Otto KJ, Lam JS, Macmillan C, Freeman JL. Diminishing diagnosis of follicular thyroid carcinoma. Head Neck. 2010;32:1629–34.

    Article  PubMed  Google Scholar 

  44. McHenry CR, Phitayakorn R. Follicular adenoma and carcinoma of the thyroid gland. Oncologist. 2011;16:585–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Woodruff SL, Arowolo OA, Akute OO, Afolabi AO, Nwariaku F. Global variation in the pattern of differentiated thyroid cancer. Am J Surg. 2010;200:462–6.

    Article  PubMed  Google Scholar 

  46. Yusuf K, Reyes-Mugica M, Carpenter TO. Insular carcinoma of the thyroid in an adolescent: a case report and review of the literature. Curr Opin Pediatr. 2003;15:512–5.

    Article  PubMed  Google Scholar 

  47. Lopez-Penabad L, Chiu AC, Hoff AO, Schultz P, Gaztambide S, Ordonez NG, Sherman SI. Prognostic factors in patients with Hurthle cell neoplasms of the thyroid. Cancer. 2003;97:1186–94.

    Article  PubMed  Google Scholar 

  48. Kebebew E, Greenspan FS, Clark OH, Woeber KA, McMillan A. Anaplastic thyroid carcinoma. Treatment outcome and prognostic factors. Cancer. 2005;103:1330–5.

    Article  PubMed  Google Scholar 

  49. Stein SA, Wartofsky L. Primary thyroid lymphoma: a clinical review. J Clin Endocrinol Metab. 2013;98:3131–8.

    Article  CAS  PubMed  Google Scholar 

  50. Lazar L, Lebenthal Y, Steinmetz A, Yackobovitch-Gavan M, Phillip M. Differentiated thyroid carcinoma in pediatric patients: comparison of presentation and course between pre-pubertal children and adolescents. J Pediatr. 2009;154:708–14.

    Article  PubMed  Google Scholar 

  51. Raval MV, Bentrem DJ, Stewart AK, Ko CY, Reynolds M. Utilization of total thyroidectomy for differentiated thyroid cancer in children. Ann Surg Oncol. 2010;17:2545–53.

    Article  PubMed  Google Scholar 

  52. Hay ID, Gonzalez-Losada T, Reinalda MS, Honetschlager JA, Richards ML, Thompson GB. Long-term outcome in 215 children and adolescents with papillary thyroid cancer treated during 1940 through 2008. World J Surg. 2010;34:1192–202.

    Article  PubMed  Google Scholar 

  53. Machens A, Lorenz K, Nguyen Thanh P, Brauckhoff M, Dralle H. Papillary thyroid cancer in children and adolescents does not differ in growth pattern and metastatic behavior. J Pediatr. 2010;157:648–52.

    Google Scholar 

  54. Ritter K, Elfenbein D, Schneider DF, Chen H, Sippel RS. Hypoparathyroidism after total thyroidectomy: incidence and resolution. J Surg Res. 2015;197:348–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Lo CY. Parathyroid autotransplantation during thyroidectomy. ANZ J Surg. 2002;72:902–7.

    Article  PubMed  Google Scholar 

  56. Puzziello A, Gervasi R, Orlando G, Innaro N, Vitale M, Sacco R. Hypocalcaemia after total thyroidectomy: could intact parathyroid hormone be a predictive factor for transient postoperative hypocalcemia? Surgery. 2015;157:344–8.

    Article  PubMed  Google Scholar 

  57. Antakia R, Edafe O, Uttley L, Balasubramanian SP. Effectiveness of preventative and other surgical measures on hypocalcemia following bilateral thyroid surgery: a systematic review and meta-analysis. Thyroid. 2015;25:95–106.

    Article  CAS  PubMed  Google Scholar 

  58. Pisanu A, Porceddu G, Podda M, Cois A, Uccheddu A. Systematic review with meta-analysis of studies comparing intraoperative neuromonitoring of recurrent laryngeal nerves versus visualization alone during thyroidectomy. J Surg Res. 2014;188:152–61.

    Article  PubMed  Google Scholar 

  59. Musacchio MJ, Kim AW, Vijungco JD, Prinz RA. Greater local recurrence occurs with “berry picking” than neck dissection in thyroid cancer. Am Surg. 2003;69:191–6 (discussion 196–7).

    Google Scholar 

  60. American Thyroid Association Surgery Working G, American Association of Endocrine S, American Academy of OH, Neck S, American H, Neck S, Carty SE, Cooper DS, Doherty GM, Duh QY, Kloos RT, Mandel SJ, Randolph GW, Stack BC, Jr, Steward DL, Terris DJ, Thompson GB, Tufano RP, Tuttle RM, Udelsman R. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid. 2009;19:1153–8.

    Google Scholar 

  61. Stack BC, Jr, Ferris RL, Goldenberg D, Haymart M, Shaha A, Sheth S, Sosa JA, Tufano RP, American Thyroid Association Surgical Affairs C. American Thyroid Association consensus review and statement regarding the anatomy, terminology, and rationale for lateral neck dissection in differentiated thyroid cancer. Thyroid. 2012;22:501–8.

    Google Scholar 

  62. Solorzano CC, Carneiro DM, Ramirez M, Lee TM, Irvin GL, 3rd. Surgeon-performed ultrasound in the management of thyroid malignancy. Am Surg. 2004;70:576–80 (discussion 580–2).

    Google Scholar 

  63. Farahati J, Reiners C, Demidchik EP. Is the UICC/AJCC classification of primary tumor in childhood thyroid carcinoma valid? J Nucl Med. 1999;40:2125.

    CAS  PubMed  Google Scholar 

  64. Giordano D, Valcavi R, Thompson GB, Pedroni C, Renna L, Gradoni P, Barbieri V. Complications of central neck dissection in patients with papillary thyroid carcinoma: results of a study on 1087 patients and review of the literature. Thyroid. 2012;22:911–7.

    Article  PubMed  Google Scholar 

  65. Machens A, Elwerr M, Thanh PN, Lorenz K, Schneider R, Dralle H. Impact of central node dissection on postoperative morbidity in pediatric patients with suspected or proven thyroid cancer. Surgery. 2016;160:484–92.

    Article  PubMed  Google Scholar 

  66. Sturgeon C, Yang A, Elaraj D. Surgical management of lymph node compartments in papillary thyroid cancer. Surg Oncol Clin N Am. 2016;25:17–40.

    Article  PubMed  Google Scholar 

  67. Sosa JA, Tuggle CT, Wang TS, Thomas DC, Boudourakis L, Rivkees S, Roman SA. Clinical and economic outcomes of thyroid and parathyroid surgery in children. J Clin Endocrinol Metab. 2008;93:3058–65.

    Article  CAS  PubMed  Google Scholar 

  68. Eustatia-Rutten CF, Smit JW, Romijn JA, Van der Kleij-Corssmit EP, Pereira AM, Stokkel MP, Kievit J. Diagnostic value of serum thyroglobulin measurements in the follow-up of differentiated thyroid carcinoma, a structured meta-analysis. Clin Endocrinol (Oxf). 2004;61:61–74.

    Article  CAS  Google Scholar 

  69. Hung W, Sarlis NJ. Current controversies in the management of pediatric patients with well-differentiated nonmedullary thyroid cancer: a review. Thyroid. 2002;12:683–702.

    Article  PubMed  Google Scholar 

  70. Brown AP, Chen J, Hitchcock YJ, Szabo A, Shrieve DC, Tward JD. The risk of second primary malignancies up to three decades after the treatment of differentiated thyroid cancer. J Clin Endocrinol Metab. 2008;93:504–15.

    Article  CAS  PubMed  Google Scholar 

  71. Fard-Esfahani A, Emami-Ardekani A, Fallahi B, Fard-Esfahani P, Beiki D, Hassanzadeh-Rad A, Eftekhari M. Adverse effects of radioactive iodine-131 treatment for differentiated thyroid carcinoma. Nucl Med Commun. 2014;35:808–17.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Daniel J. Ledbetter .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer-Verlag GmbH Germany

About this chapter

Cite this chapter

Ledbetter, D.J. (2018). Thyroid Cancer in Children. In: Ledbetter, D., Johnson, P. (eds) Endocrine Surgery in Children. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54256-9_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-54256-9_4

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-54254-5

  • Online ISBN: 978-3-662-54256-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics