Garzi A, Prestipino M, Calabrò E, Di Crescenzo R M, Rubino M S
Division of Pediatric M.I.S. and Robotic Surgery University of Salerno, Italy.
Division of Pediatric Surgery A.O. S. Maria della Misericordia Perugia, Italy.
Transl Med UniSa. 2020 May 31;22:28-32. eCollection 2020 May.
In children, differentiated thyroid carcinoma is a rare condition. Early diagnosis is not always easy, because of the lack of clinical symptoms, but it has a pivotal role in performing a correct therapeutic process. The study describes three cases of papillary thyroid carcinoma. None of the three patients had a positive familiarity or exposure to risk factors. In two cases, the tumor occurred as a non-injurious swelling in the anterior cervical region, in the other case it occurred with a latero-cervical lymphadenopathy that had been persistent for a year. In the first two patients we made a certain diagnosis by the needle aspiration of the thyroid nodule; in the other case the diagnosis was made by surgical exeresis and histological analysis of the lymph nodes. We also performed blood chemistry and hormonal tests, neck ultrasound, chest x-ray. The three children underwent total thyroidectomy and two of them also underwent right-sided cervical lymph node exeresis because there was the presence of metastasis. In our experience, the best therapeutic strategy for children with differentiated thyroid carcinoma is the total thyroidectomy, followed or not by latero-cervical lymph node exeresis and radioiodiotherapy. The removal of the whole gland reduces the risk of relapse.
在儿童中，分化型甲状腺癌是一种罕见疾病。由于缺乏临床症状，早期诊断并非总是容易，但它在正确的治疗过程中起着关键作用。该研究描述了三例乳头状甲状腺癌病例。这三名患者均无家族性阳性史或接触危险因素。在两例中，肿瘤表现为颈前区无痛性肿块，另一例则表现为持续一年的颈侧淋巴结病。在前两名患者中，通过甲状腺结节细针穿刺做出了明确诊断；另一例则通过手术切除和淋巴结组织学分析做出诊断。我们还进行了血液化学和激素检查、颈部超声、胸部X光检查。这三名儿童均接受了甲状腺全切除术，其中两名儿童因存在转移还接受了右侧颈淋巴结切除术。根据我们的经验，分化型甲状腺癌儿童的最佳治疗策略是甲状腺全切除术，之后可根据情况进行或不进行颈侧淋巴结切除术及放射性碘治疗。切除整个腺体可降低复发风险。
