Differentiated thyroid cancer in children: Pediatrics Meet 2018

Differentiated thyroid cancer (DTC) includes papillary thyroid cancer and follicular thyroid cancer. Papillary thyroid cancer is the most common form of thyroid cancer in both children and adults and represents about 85 to 90 percent of all DTC diagnoses. Follicular thyroid cancer accounts for only 5 to 10 percent of pediatric patients with differentiated thyroid cancer.

Papillary thyroid cancer (PTC) in children and adolescents does not behave the same as it does in adult patients. Even when PTC has spread to the lymph nodes or lungs, pediatric patients with the disorder have much better outcomes compared to adults. About 40 to 60 percent of children diagnosed with differentiated thyroid cancer will have papillary thyroid cancer that has spread to the lymph nodes; for about 15 percent, the PTC has spread to their lungs.

Unlike papillary thyroid cancer, follicular thyroid cancer (FTC) is usually found as a solitary thyroid nodule. While follicular thyroid cancer has less chance of spreading to the lymph nodes in the neck, there is a higher chance of cancer spreading to distant sites in the body, such as the bones, because FTC can invade blood vessels.

No matter how much cancer has spread, pediatric patients with differentiated thyroid cancer have more than a 95 percent survival rate 20 to 30 year after treatment. When properly evaluated and treated, many pediatric patients with differentiated thyroid cancer will go on to lead productive and rewarding lives.

Clinical experts may use a variety of diagnostic tests including:

Ø  Blood test to measure the thyroid-stimulating hormone (TSH) level to determine how well your child’s thyroid is working.

Ø  Thyroid ultrasound (or thyroid scan) to learn about the size, number, appearance and location of any thyroid nodules and abnormal lymph nodes.

Ø  Fine-needle aspiration (FNA) to collect cells from the thyroid, and possibly lymph nodes, to be examined under a microscope.

A nuclear medicine uptake and the scan will be ordered if your child’s TSH level is low or suppressed. This test determines how well the thyroid tissues are absorbing iodine.