Nasser Tariq, Altirkistani Bsaim Abdulsalam, Bougis Suaad Muhammad, Abu Ghasham Asma Hassan, Nafadi Ibrahim Basem
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU.
Department of Medicine/Endocrinology, King Abdullah International Medical Research Center, Jeddah, SAU.
Cureus. 2024 Aug 2;16(8):e65992. doi: 10.7759/cureus.65992. eCollection 2024 Aug.
Objective Differentiated thyroid cancer (DTC) is rare in the pediatric population, with most data from the Western world. We aimed to describe the clinical presentation, treatment intervention, histopathological characteristics, complications, follow-up, and response to treatment in 17 patients with DTC at or below the age of 20 years. Interventions This was a retrospective cohort study at King Abdulaziz Medical City, Jeddah, Saudi Arabia. We included patients aged younger than 20 years with DTC. Total or near-total thyroidectomy was performed in 82% of the patients, central and/or lateral neck dissection in 35% of cases, and radioactive iodine (RAI) ablation in 76% of cases. Results The study included 17 patients (14 females), with a median age of 16 years at the time of diagnosis. Thyroid nodules were the main complaint in 88% of the patients. Thyroid ultrasonography was the main method for the initial evaluation. Papillary cancer was the most common type of tumor, and lymph node spread was found in 82% of the patients. Moreover, 40% of the patients exhibited excellent responses to therapy, with 35% showing indeterminate results. Only 23.5% of the patients developed hypocalcemia postoperatively. Conclusions Classical papillary thyroid carcinoma was the predominant histopathological type, and most patients showed excellent responses to therapy, followed by indeterminate in most of the cases. The most common presentation was a neck nodule, signifying the role of thorough physical neck examinations. Finally, recurrence occurred in a minority of patients. However, none of these patients died.
目的 分化型甲状腺癌（DTC）在儿科人群中较为罕见，多数数据来自西方世界。我们旨在描述17例20岁及以下DTC患者的临床表现、治疗干预、组织病理学特征、并发症、随访情况及治疗反应。
干预措施 这是一项在沙特阿拉伯吉达阿卜杜勒阿齐兹国王医疗城进行的回顾性队列研究。我们纳入了年龄小于20岁的DTC患者。82%的患者接受了全甲状腺切除或近全甲状腺切除，35%的病例进行了中央和/或侧颈淋巴结清扫，76%的病例进行了放射性碘（RAI）消融。
结果 该研究纳入了17例患者（14例女性），诊断时的中位年龄为16岁。88%的患者主要症状为甲状腺结节。甲状腺超声是初始评估的主要方法。乳头状癌是最常见的肿瘤类型，82%的患者发现有淋巴结转移。此外，40%的患者对治疗表现出良好反应，35%的结果不确定。只有23.5%的患者术后出现低钙血症。
结论 经典型乳头状甲状腺癌是主要的组织病理学类型，大多数患者对治疗表现出良好反应，多数病例其次是结果不确定。最常见的表现是颈部结节，这表明颈部全面体格检查的重要性。最后，少数患者出现复发。然而，这些患者均无死亡。
