Division of Pediatric Surgery, Department of Surgery, Yale University School of Medicine, 330 Cedar Street, PO Box 208062, New Haven, CT, USA.
Division of General and Thoracic Surgery, The Hospital for Sick Children, Room 1524, 555 University Ave, Toronto, ON M5G 1X8, Canada.
Surg Oncol Clin N Am. 2021 Apr;30(2):235-251. doi: 10.1016/j.soc.2020.11.013. Epub 2021 Jan 29.
Differentiated thyroid carcinomas are rare in young children but represent almost 10% of all malignancies diagnosed in older adolescents. Differentiated thyroid carcinoma in children is more likely to demonstrate nodal involvement and is associated with higher recurrence rates than seen in adults. Decisions regarding extent of surgical resection are based on clinical and radiologic features, cytology, and risk assessment. Total thyroidectomy and compartment-based resection of involved lymph node basins form the cornerstone of treatment. The use of molecular genetics to inform treatment strategies and the use of targeted therapies to unresectable progressive disease is evolving.
儿童分化型甲状腺癌较为罕见,但在青少年中占所有恶性肿瘤的近 10%。儿童分化型甲状腺癌更易发生淋巴结转移,且复发率高于成人。手术切除范围的决策取决于临床和影像学特征、细胞学和风险评估。全甲状腺切除术和受累淋巴结盆基于解剖部位的切除术是治疗的基石。利用分子遗传学来指导治疗策略,以及使用针对不可切除进展性疾病的靶向治疗正在不断发展。