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      Thyroid Carcinoma in Children and Adolescents—Systematic Review of the Literature

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          Abstract

          Thyroid cancer in children and adolescents is usually a major concern for physicians, patients, and parents. Controversies regarding the aggressiveness of the clinical presentation and the ideal therapeutic approach remain among the scientific community. The current recommendations and staging systems are based on data generated by studies in adults, and this might lead to overtreating in some cases as well as undertreating in others. Understanding the differences in the biology, clinical course, and outcomes in this population is crucial for therapeutic decisions. This paper evaluates the biology, clinical presentation, recurrences, and overall survival as well as the staging systems in children and adolescents with differentiated thyroid cancer.

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          RAS point mutations and PAX8-PPAR gamma rearrangement in thyroid tumors: evidence for distinct molecular pathways in thyroid follicular carcinoma.

          G Dorn, Erik Alexander, T Lynch … (2003)
          A series of 88 conventional follicular and Hürthle cell thyroid tumors were analyzed for RAS mutations and PAX8-PPAR gamma rearrangements using molecular methods and for galectin-3 and HBME-1 expression by immunohistochemistry. A novel LightCycler technology-based method was developed to detect point mutations in codons 12/13 and 61 of the H-RAS, K-RAS, and N-RAS genes. Forty-nine percent of conventional follicular carcinomas had RAS mutations, 36% had PAX8-PPAR gamma rearrangement, and only one (3%) had both. In follicular adenomas, 48% had RAS mutations, 4% had PAX8-PPAR gamma rearrangement, and 48% had neither. Follicular carcinomas with PAX8-PPAR gamma typically showed immunoreactivity for galectin-3 but not for HBME-1, tended to present at a younger patient age and be smaller size, and were almost always overtly invasive. In contrast, follicular carcinomas with RAS mutations most often displayed an HBME-1-positive/galectin-3-negative immunophenotype and were either minimally or overtly invasive. Hürthle cell tumors infrequently had PAX8-PPAR gamma rearrangement or RAS mutations. These results suggest that conventional follicular thyroid carcinomas develop through at least two distinct and virtually nonoverlapping molecular pathways initiated by either RAS point mutation or PAX8-PPAR gamma rearrangement.
          Article 0 comments Cited 132 times – based on 0 reviews     Review now
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            Thyroid Cancer after Exposure to External Radiation: A Pooled Analysis of Seven Studies

            Elaine Ron, Jay H. Lubin, Roy E. Shore … (1995)
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              Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients.

              Anthony R. Hogan, Ying Zhuge, Eduardo A Perez … (2009)
              To examine outcomes and predictors of survival for pediatric patients with thyroid carcinoma. The Surveillance, Epidemiology, and End Results (SEER) registry from 1973 to 2004 was queried for all patients with thyroid carcinoma less than 20 y of age. A total of 1753 patients with malignant thyroid neoplasms were identified with an age-adjusted annual incidence of 0.54 cases per 100,000 persons. There has been a significant increase in the annual incidence by 1.1% per y. Female patients outnumbered males 4 to 1. Tumors were classified as papillary (n=1044, 60%), follicular variant of papillary (n=389, 23%), follicular (n=165, 10%), and medullary (n=87, 5%). The majority of patients presented with localized and regional disease. Overall mean survival time (MST) was 30.5 y. The MST for females was 40 y, whereas males survived an average of 20.4 y (P=0.0001). Patients with medullary cancer had significantly shorter mean survival than those with papillary cancer (P=0.006). Surgical treatment significantly improved outcome. Multivariate analysis demonstrated that male gender, nonpapillary histology, distant disease, and no surgery were all independent prognostic factors of worse outcome. For patients with medullary thyroid carcinoma, radiation therapy was also identified as an independent predictor of lower survival. The incidence of pediatric thyroid cancer is increasing. Females have a higher incidence than males, but enjoy longer survival. Papillary thyroid cancer has overall excellent survival. Male gender, nonpapillary tumor, distant metastases, and nonsurgical treatment all predict worse outcome.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Thyroid Res
                Journal ID (publisher-id): JTR
                Title: Journal of Thyroid Research
                Publisher: SAGE-Hindawi Access to Research
                ISSN (Print): 2090-8067
                ISSN (Electronic): 2042-0072
                Publication date (Print): 2011
                Publication date (Electronic): 4 September 2011
                Volume: 2011
                Electronic Location Identifier: 845362
                Affiliations
                1Endocrinology Service, Universidade Federal do Rio de Janeiro, Rio de Janiro, RJ, Brazil
                2Endocrinology Service, Instituto Nacional do Cancer, Rio de Janeiro, Rio de Janiro, RJ, Brazil
                Author notes
                *Fernanda Vaisman: fevaisman@ 123456globo.com

                Academic Editor: Ana O. Hoff

                Article
                DOI: 10.4061/2011/845362
                PMC ID: 3166725
                PubMed ID: 21904689
                SO-VID: 80db32cc-2257-4fe7-9964-26f92737a2fd
                Copyright © Copyright © 2011 Fernanda Vaisman et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 21 December 2010
                Date revision received : 8 April 2011
                Date accepted : 9 May 2011
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Endocrinology & Diabetes
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes

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