Uchino J, Hata Y, Kasai Y
Jpn J Surg. 1978 Mar;8(1):19-27. doi: 10.1007/BF02469331.
Thyroid cancer in childhood is a relatively rare condition. Often it shows biological characteristics different from those seen in adults. Based upon 10 cases in our clinic and 57 cases collected from the Japanese literatures, clinical features, pathology, treatment and prognosis of thyroid cancer in childhood are discussed. Pathogenesis is most likely to be related to hormonal changes during adolescence and previous radiation of the neck region. Cervical lymph nodes swelling was the chief complaint in 84.6 per cent of the cases. On the other hand, pulmonary metastases were recognized in the early stages in 33.5 per cent of the cases. Radical excision of the tumor with modified radical neck dissection is the treatment most frequently employed even in the presence of lung metastases. However, hypoparathyroidism and recurrent nerve injuries should be avoided at all cost in view of long life expectancy and the difficulty in treating them satisfactorily. Prognosis could be as good for children as it is for adults except in cases with early lung metastases.
儿童甲状腺癌是一种相对罕见的病症。它通常表现出与成人甲状腺癌不同的生物学特征。基于我们诊所的10例病例以及从日本文献中收集的57例病例,对儿童甲状腺癌的临床特征、病理、治疗及预后进行了讨论。发病机制很可能与青春期的激素变化以及先前颈部区域的辐射有关。84.6%的病例主要症状为颈部淋巴结肿大。另一方面,33.5%的病例在早期就出现了肺转移。即使存在肺转移,最常采用的治疗方法仍是肿瘤根治性切除加改良根治性颈清扫术。然而,鉴于儿童预期寿命长且难以令人满意地治疗甲状旁腺功能减退症和喉返神经损伤,应不惜一切代价避免这些情况的发生。除了早期出现肺转移的病例外,儿童甲状腺癌的预后与成人一样良好。