2022 European Thyroid Association Guidelines for the management of pediatric thyroid nodules and differentiated thyroid carcinoma

Abstract

At present no European recommendations for the management of pediatric thyroid nodules and differentiated thyroid carcinoma (DTC) exist. Differences in clinical, molecular, and pathological characteristics between pediatric and adult DTC emphasize the need for specific recommendations for the pediatric population. An expert panel was instituted by the executive committee of the European Thyroid Association (ETA) including an international community of experts from a variety of disciplines including pediatric and adult endocrinology, pathology, endocrine surgery, nuclear medicine, clinical genetics, and oncology. The American Thyroid Association (ATA) pediatric guideline 2015 was used as framework for the present guideline. Areas of discordance were identified, and clinical questions were formulated. The expert panel members discussed the evidence and formulated recommendations based upon the latest evidence and expert opinion. Children with a thyroid nodule or DTC require expert care in an experienced center. The present guideline provides guidance for healthcare professionals to make well-considered decisions together with patients and parents regarding diagnostics, treatment and follow-up of pediatric thyroid nodules and DTC.

The Prognostic Significance of BRAF Gene Analysis in Children and Adolescents with Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

“…Tumor size is the first element that guides the management algorithm of a thyroid nodule management and, thus, appears as an important variable in the risk stratification of a PTC by TNM grading. Diameters larger than 1 cm are defined as the precursor for a more aggressive oncogenic behaviour [ 1 , 21 ], independently of the BRAF V600E mutation. It is obvious that differences in the reporting of tumor size over time are significantly correlated with the improvement of ultrasound diagnostic ability, combined with higher qualifications and awareness among health professionals.…”

“…Furthermore, the BRAF V600E mutation is not clearly associated with distinct negative clinicopathological features and does not predict an unfavourable course, in contrast to adult PTC [ 12 , 13 , 18 , 20 ]. In the recently published European Thyroid Association Guidelines for the management of pediatric thyroid nodules and differentiated thyroid cancer (DTC), the authors recommend that the molecular gene analysis for the presence of BRAF V600E mutation in a fine-needle aspiration (FNA) specimen may be useful for diagnosis of PTC and therefore may be incorporated into the diagnostic work-up [ 21 ]. However, the use of BRAFV600E as a molecular marker in pediatric and adolescent PTC remains controversial.…”

Second Primary Malignancies in Patients with Differentiated Thyroid Cancer after Radionuclide Therapy: A Retrospective Single-Centre Study

“…In this context, it should be considered that the pediatric population has been excluded from the final analysis in light of known differences between adult and pediatric DTC regarding clinical, molecular, and pathological characteristics [31]. Thus, specific investigations for the pediatric population are needed.…”

Importancia del manejo multidisciplinario en el paciente con cáncer de tiroides diferenciado

“…Por lo general, crece lentamente y, a menudo, se detecta en una etapa temprana. El DTC folicular es menos frecuente y, por lo general, es más agresivo que el cáncer papilar (Lebbink et al 2022). Por otro lado, un tercer tipo de DTC es el anaplásico, el cual es el más extraño de los DTC.…”