Journal of clinical research in pediatric endocrinology | 2021
Long-term Follow-up of a Toddler with Papillary Thyroid Carcinoma: A Case Report with a Literature Review of Patients Under 5 Years of Age.
Abstract
Papillary thyroid cancer (PTC) is extremely rare in children. Herein, we present a case diagnosed with PTC at 15 months of age. We conducted a literature review of the published cases with PTC under five years of age. A 13/12 -year-old male patient had initially presented with a complaint of progressively enlarging cervical mass that appeared four months ago. On physical examination, a mass located on the anterior cervical with the largest measuring 3x3cm was detected. Cervical and thyroid ultrasonography showed a 50x27 mm in size solid mass in the right lateral neck. Excisional biopsy revealed a follicular variant of PTC with capsular invasion. Subsequently, he underwent a complementary total thyroidectomy. He was diagnosed with intermediate-risk (T3N0M0) PTC. He developed permanent hypoparathyroidism. At the first year of the operation, he was treated with radioiodine ablation (RAI) since basal and stimulated thyroglobulin (Tg) levels tended to increase. Whole body scintigraphy was normal in the first year of RAI ablation. On LT4 treatment, levels of TSH and Tg were adequately suppressed. He is now 86/12-year-old and disease-free on LT4 suppression therapy for seven years and three months. PTC has different biological behavior and a great prognosis compared to adults. The optimal treatment strategy for pediatric TC is total thyroidectomy, followed by RAI ablation. A regular follow-up with TSH suppression by thyroxin, serial thyroglobulin evaluation, and radioiodine scanning, when indicated, are the necessary follow-up procedures.