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      Cáncer de tiroides en pediatría Translated title: Pediatric Thyroid Cancer

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          Abstract

          RESUMEN: El cáncer de tiroides es una enfermedad rara en la edad pediátrica que está aumentando en los últimos años, principalmente en mujeres adolescentes. Aunque guarda similitudes con el cáncer tiroideo del adulto tiene una serie de peculiaridades que lo diferencian. Nuestro objetivo es mostrar estas diferencias, resaltando las particularidades de esta enfermedad en la edad pediátrica frente a la del adulto. Los avances en las técnicas diagnósticas de genética molecular han permitido nuevos descubrimientos acerca de la génesis de tumores tiroideos en edades tempranas. También han supuesto un incremento de los diagnósticos de síndromes de predisposición genética, principalmente MEN2A, que ha producido un aumento significativo de tiroidectomías profilácticas. Los tipos histológicos más frecuentes son los cánceres diferenciados, principalmente el papilar. Al diagnóstico en edad pediátrica, suelen presentar un mayor tamaño, extensión, y probabilidades de multifocalidad y metástasis que en el adulto. A corto plazo el pronóstico es excelente; sin embargo, a largo plazo existe un número importante de recaídas y de aparición de segundos tumores. Para su tratamiento y seguimiento son necesarias unidades de alta especialización pediátrica que incluyan cirujanos expertos en tiroides. Se debe tender a la medicina personalizada estableciendo protocolos diagnósticos que caractericen correctamente el tumor y estratifiquen el pronóstico, adaptando la cirugía, la administración de yodo-131 y los nuevos tratamientos farmacológicos para buscar la máxima efectividad y supervivencia y minimicen los efectos secundarios.

          Translated abstract

          SUMMARY; Thyroid cancer is a rare disease in paediatric age; however, it is increasing in the last few years, mainly in adolescent women. Although children and adult thyroid cancer are similar, they have some differences. The aim of this report is to analyse those differences, emphasizing the particularities of thyroid cancer in paediatric age. The development of molecular genetic testing has allowed a deeper understanding of genetic predisposition syndromes, such as MEN2A, which has led to a significant increase in prophylactic thyroidectomies. The most frequent histological group is differentiated cancer, specifically papillary type. At the time of diagnosis in children thyroid cancer presents a greater size and extension, and more probabilities of multifocality and metastasis than in adults. The short-term prognosis is excellent; however, in the long-term there are a significant number of recurrences and second tumours. It is important to carry out a personalized medicine, and to create diagnostic protocols. A Deep tumour characterization and the prognosis stratification will be essential to choose the correct treatment for each case, also to achieve maximum effectiveness, survival and to minimize side effects.

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          Most cited references53

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          2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.

          Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer.
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            Integrated genomic characterization of papillary thyroid carcinoma.

            (2014)
            Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. Here, we describe the genomic landscape of 496 PTCs. We observed a low frequency of somatic alterations (relative to other carcinomas) and extended the set of known PTC driver alterations to include EIF1AX, PPM1D, and CHEK2 and diverse gene fusions. These discoveries reduced the fraction of PTC cases with unknown oncogenic driver from 25% to 3.5%. Combined analyses of genomic variants, gene expression, and methylation demonstrated that different driver groups lead to different pathologies with distinct signaling and differentiation characteristics. Similarly, we identified distinct molecular subgroups of BRAF-mutant tumors, and multidimensional analyses highlighted a potential involvement of oncomiRs in less-differentiated subgroups. Our results propose a reclassification of thyroid cancers into molecular subtypes that better reflect their underlying signaling and differentiation properties, which has the potential to improve their pathological classification and better inform the management of the disease.
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              ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee.

              Thyroid nodules are a frequent finding on neck sonography. Most nodules are benign; therefore, many nodules are biopsied to identify the small number that are malignant or require surgery for a definitive diagnosis. Since 2009, many professional societies and investigators have proposed ultrasound-based risk stratification systems to identify nodules that warrant biopsy or sonographic follow-up. Because some of these systems were founded on the BI-RADS(®) classification that is widely used in breast imaging, their authors chose to apply the acronym TI-RADS, for Thyroid Imaging, Reporting and Data System. In 2012, the ACR convened committees to (1) provide recommendations for reporting incidental thyroid nodules, (2) develop a set of standard terms (lexicon) for ultrasound reporting, and (3) propose a TI-RADS on the basis of the lexicon. The committees published the results of the first two efforts in 2015. In this article, the authors present the ACR TI-RADS Committee's recommendations, which provide guidance regarding management of thyroid nodules on the basis of their ultrasound appearance. The authors also describe the committee's future directions.
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                Author and article information

                Journal
                orl
                Revista ORL
                Rev. ORL
                Ediciones Universidad de Salamanca (Salamanca, Salamanca, Spain )
                2444-7986
                December 2021
                : 12
                : 4
                : 303-312
                Affiliations
                [1] orgnameHospital Universitario de Salamanca orgdiv1Unidad de Endocrinología Pediátrica España
                [3] orgnameHospital Universitario de Salamanca orgdiv1Unidad de Oncohematología Pediátrica España
                [2] orgnameHospital Universitario de Salamanca orgdiv1Unidad de Radiología España
                [4] Pamplona orgnameClínica Universitaria de Navarra orgdiv1Departamento de Otorrinolaringología España
                Article
                S2444-79862021000400003 S2444-7986(21)01200400003
                10.14201/orl.25061
                e59b8926-4403-4d87-8eee-bb514b15357e

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 07 November 2020
                : 04 December 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 53, Pages: 10
                Product

                SciELO Spain

                Categories
                Artículo de revisión

                thyroid cancer,genetic testing,differentiated thyroid cancer,paediatric thyroid cancer,niños,test genéticos,cáncer diferenciado de tiroides,cáncer tiroideo pediátrico,cáncer de tiroides,children

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