Segal K, Hadar T, Lubin E, Abraham A, Levy R
Dept. of Otolaryngology, Beilinson Medical Center, Petah Tikva.
Harefuah. 1992 Jan 15;122(2):83-6.
Of the 720 patients with thyroid cancer we saw from 1953 to 1989, 49 were younger than 20 years at diagnosis, and the female/male ratio was 4.4:1. The histologic type was papillary in 34, follicular in 14 and medullary in 1. Initial treatment in 41 was total or near-total thyroidectomy, and in 8 hemithyroidectomy. 23 underwent neck dissection in addition to thyroidectomy. 49% of those who underwent total thyroidectomy had foci of bilateral thyroid carcinoma on serial histological section. Local and distant relapse of thyroid carcinoma occurred in 4 of the 8 who underwent hemithyroidectomy, but in only 1 of the 41 who underwent total thyroidectomy. Our recommendations include total thyroidectomy, radioiodine therapy, and modified neck dissection when neck metastases are presented.
在1953年至1989年间我们诊治的720例甲状腺癌患者中，49例在确诊时年龄小于20岁，男女比例为4.4:1。组织学类型为乳头状癌34例，滤泡状癌14例，髓样癌1例。41例患者的初始治疗为甲状腺全切除术或近全切除术，8例为甲状腺次全切除术。23例除甲状腺切除外还接受了颈部清扫术。接受甲状腺全切除术的患者中，49%在连续组织学切片上有双侧甲状腺癌灶。接受甲状腺次全切除术的8例患者中有4例发生了甲状腺癌局部和远处复发，但接受甲状腺全切除术的41例患者中仅1例复发。我们的建议包括甲状腺全切除术、放射性碘治疗，以及出现颈部转移时行改良颈部清扫术。
