Growth retardation can be due to inadequate growth hormone secretion or lack of biological response to Us effects. The clinical picture is quite similar in both conditions. Growth hormone exerts its biological effects through cellular receptors which, if absenl, can lead to growth retardation. We present a 14 year 7 month old boy with extreme short stalure [heighl 95 cmj, centripetal obesity, small hands and feets, miaopenis, and immature facies, which suggested growth hormone deficiency. His serum growth hormone concentrations were elevated, and his somatomedin-C was decreased. The boy was treated with growth hormone and he did not show any biochemical or clinical response, suggesting that he has growth hormone resistance.

Clinical aspects of thyroid carcinoma in children Nine patients with thyroid carcinoma, 4 boys and 5 girls, aged 3 to 16 years are described. Their clinical signs went on from hard goiter, through those of mild symptoms of local compression, to evidence of metastases. Thyroid function was normal in these patients and thyroid scintigraphic scans revealed focal low or absent radio iodine uptake. The pathologic study revealed in all them differenciated thyroid carcinomas: 4 papillary cancers associated to chronic thyroidits in 3; 3 cases of papillar-folicular carcinomas and 2 of medullar carcinomas without familiar antecedents. The treatment of choice was total thyroidectomy, for possible multifocal compromise, together with affected adjacent lymph nodes remotion. Post-operative thyroid hormone treatment at TSH suppressive dose was also indicated. Post operative evolution was satisfactory, but secondary hypoparathyroidism ocurred in 3 patients. Early diagnosis of thyroid carcinoma affords relatively good prognosis.