Meller J, Conrad M, Behr T, Gratz S, Becker W
Abt. Nuklearmedizin der Georg-August-Universität Göttingen.
Klin Padiatr. 1998 Sep-Oct;210(5):373-8. doi: 10.1055/s-2008-1043907.
Differentiated thyroid cancer is a rare disease in childhood and adolescence. Most frequently, thyroid cancer in children belongs to the papillary variant, whereas a follicular histological pattern is much less frequently encountered. Dedifferentiated (anaplastic) cancers are very rare at this age. Especially indolent cervical lymph node enlargement is suspicious for a thyroid cancer, even more when occurring together with a solitary, rapidly growing, and indurated thyroid nodule. Every nodule in the thyroid of children and adolescents, if not unequivocally cystic, is suspicious of a malignancy. In contrast to adults, multifocal tumor manifestations are frequently found in children and adolescents which often have spread beyond the capsule of the thyroid at the time of diagnosis. Regional lymph nodes are involved in up to 90%, and distant metastases are present in up to 20% of the cases. Despite these much more advanced stages as usually found in adults, the prognosis of children is better than at advanced age, since these tumors are highly differentiated, and, even in the case of distant metastases, a curative approach is still possible. The therapy (surgery/radioiodine) and the follow-up follows the same principles as those which have been established for older patients.
分化型甲状腺癌在儿童和青少年中是一种罕见疾病。儿童甲状腺癌最常见的是乳头状亚型，而滤泡状组织学类型则较少见。去分化（间变性）癌在这个年龄段非常罕见。特别是无痛性颈部淋巴结肿大应怀疑为甲状腺癌，若同时伴有单个、快速生长且质地硬的甲状腺结节则更可疑。儿童和青少年甲状腺内的每个结节，若不是明确的囊性结节，都应怀疑为恶性。与成人不同，儿童和青少年常出现多灶性肿瘤表现，在诊断时肿瘤往往已超出甲状腺包膜。区域淋巴结受累率高达90%，远处转移率高达20%。尽管这些病例的分期通常比成人更晚，但儿童的预后比成年人好，因为这些肿瘤分化程度高，即使发生远处转移，仍有可能采用治愈性治疗方法。治疗（手术/放射性碘）及随访遵循与成年患者相同的原则。
