Thyroid Cancer in Childhood

From 1956 to 1975 21 patients (13 females and 8 males) with thyroid cancer developed by age 14 have been observed at the Istituto Nazionale Tumori of Milan. Follicular adenocarcinoma was diagnosed in 4 cases and papillary adenocarcinoma in 17. Five patients (24%) had been given previous cervical irradiation for benign conditions. At admission lung metastases were evident in 2 patients (one affected by follicular and the other by papillary adenocarcinoma). All patients were submitted to surgical treatment, which in most cases consisted in total thyroidectomy plus elective lymph node dissection; serious postoperative complications were not observed. External irradiation was given to 4 patients, since surgery had not been radical. Radioiodine treatment was performed in the 2 patients with lung metastases: in the patient with follicular adenocarcinoma metastases disappeared after 131I treatment, whereas in the other one they still persist unmodified 10 years later. A local recurrence occurred in 3 cases and pulmonary metastases in one: all of them made an apparent recovery after surgical and/or radioiodine treatment. All patients are alive and, except one, without evidence of disease after a follow-up period from 14 months to 21 years. Although differences in evolution have been noted according to the histotype, the prognosis of thyroid cancer in childhood is good, evenif distant metastases are present.