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Luiz Paulo Kowalski, MD, PhD; João Gonçalves Filho, MD; Clóvis Antonio Lopes Pinto, MD; André Lopes Carvalho, MD; Beatriz de Camargo, MD, PhD

Arch Otolaryngol Head Neck Surg. 2003;129:746-749.

Background  Thyroid carcinoma in patients younger than 18 years is rare. It is associated with a greater risk of metastases. However, the prognosis for these patients is better when compared with that of adults.

Objective  To present the experience of a single institution in the treatment of patients with thyroid carcinoma during childhood and adolescence.

Patients and Methods  Thirty-eight patients, ranging in age from 4 to 18 years, were diagnosed as having thyroid carcinoma. Pathologic types of carcinoma included 29 papillary, 4 follicular, 1 Hürthle cell, and 4 medullary cases.

Results  Hypocalcemia was the main complication, being transitory in 9 patients (24%) and permanent in 6 patients (16%). Vocal cord palsy occurred in 2 patients (5%). Two patients (5%) had a surgical site infection. After a mean follow-up of 9.5 years (range, 1-40 years), 28 patients (74%) were alive and had no evidence of disease, 3 (8%) were alive and had recurrent disease, 4 (11%) died (2 of the disease and 2 of non–cancer-related causes), and 3 (8%) were lost to follow-up. The survival rates at 10 years for the patients with papillary, follicular, and medullary carcinoma were 93%, 100%, and 50%, respectively.

Conclusions  Thyroid carcinoma in patients younger than 18 years has a good prognosis even in the presence of neck or distant metastasis. Total thyroidectomy, associated with adjuvant radioactive iodine therapy and thyroidal suppression or not, is effective in patients with a well-differentiated thyroid carcinoma.

From the Departments of Head and Neck Surgery and Otorhinolaryngology (Drs Kowalski, Gonçalves, Filho, and Carvalho), Pathology (Dr Pinto), and Pediatric Oncology (Dr de Camargo), Centro de Tratamento e Pesquisa Hospital do Câncer A. C. Camargo, São Paulo, Brazil. The authors have no relevant financial interest in this article.

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