Josefson Jami, Zimmerman Donald
Division of Endocrinology, Children's Memorial Hospital, Chicago, IL 60614, USA.
Pediatr Endocrinol Rev. 2008 Sep;6(1):14-23.
The incidence of thyroid nodules in children is estimated to be 1 to 1.5% based on clinical examination. Children with thyroid nodules, compared to adults with thyroid nodules, have a fourfold greater risk of developing malignant thyroid disease. Differentiated thyroid carcinoma is the most common pediatric endocrine tumor, constituting 0.5-3% of all childhood malignancies. The thyroid is one of the most frequent sites of secondary neoplasm in children who receive radiation therapy for other malignancies. Thyroid carcinoma has been studied extensively in adults. However, the pediatric literature on this subject is much less complete, owing to the rarity of its diagnosis. This article reviews the predisposing factors, genetics, pathology, pathogenesis , clinical presentation, detailed treatment and follow-up management of children with thyroid carcinoma. Additionally, a discussion regarding the controversial aspects of radioiodine therapy in children is included.
根据临床检查估计,儿童甲状腺结节的发病率为1%至1.5%。与成人甲状腺结节患者相比,儿童甲状腺结节患者发生甲状腺恶性疾病的风险高四倍。分化型甲状腺癌是最常见的儿童内分泌肿瘤,占所有儿童恶性肿瘤的0.5% - 3%。甲状腺是接受其他恶性肿瘤放射治疗的儿童继发性肿瘤最常见的部位之一。甲状腺癌在成人中已得到广泛研究。然而,由于其诊断罕见,关于这一主题的儿科文献要少得多。本文综述了儿童甲状腺癌的易感因素、遗传学、病理学、发病机制、临床表现、详细治疗及随访管理。此外,还讨论了儿童放射性碘治疗的争议性问题。