Factors associated with resistant disease in pediatric differentiated thyroid carcinomas

Abstract

Purpose: Thyroid carcinoma is the most common carcinoma that originated from endocrine tissue in pediatric patients. Pediatric thyroid carcinomas are more prone to reveal lymph node or lung metastasis and recurrence. In this study, clinical, pathological and genetic features that may be related with resistant differentiated thyroid carcinoma in pediatric patients were investigated.
 Materials and Methodsː Thirty-nine pediatric patients who were 18 years old and below and were given 131I Radioactive Iodine (RAI) therapy were included to the study. 131I RAI therapy was planned in accordance with the American Thyroid Association (ATA) Guideline. Clinical and postoperative pathological features of patients were retrospectively determined and the patients who received single or multiple RAI therapy due to resistant disease compared statistically in terms of these features. Genetic analysis was also made in the patients who received multiple therapies. 
 Resultsː Thirty-one patients were female and 8 patients were male. Thirty-four patients had papillary thyroid carcinoma, 4 had follicular thyroid carcinoma and 1 had mixed papillary-oncocytic carcinoma of patients. Eight patients received multiple I-131 RAI therapy cycles due to resistant disease. Any clinical, pathological feature and genetic mutation that would indicate resistant disease was not found in these patients. 
 Conclusionː Although pediatric thyroid carcinoma is rarely seen, it has an increasing incidence in recent years. We were not able to reveal any feature related to resistant disease in our limited group. Clinical, pathological and genetic characteristics related to poor prognosis must be investigated with larger study groups.